In the 2013 movie The Lunchbox a desperately unhappy housewife suggests moving to Bhutan in one of her notes to her pen-pal. She believes that everyone there is happy because there is no ‘Gross Domestic Product, only Gross National Happiness (GNH). In addition to her literal escape, Bhutan played the role of a symbol for happiness throughout the movie. Although not perfect, frameworks like GNH can paint a more holistic picture of a nation’s collective level of wellbeing by considering seven basic indicators including economic, environmental, physical, mental, workplace, social and political wellness. It got me thinking – what would Pakistan look like if viewed through this kind of lens?
What follows is a rudimentary breakdown of Pakistan’s performance across these indicators, which systemically presents a picture of the severe discontent permeating our national psyche. At this point anyone faint of heart, sensitive or generally hopeful about the country is advised to put down the paper, have a cup of tea, grab a bowl of ice-cream or curl up in a ball and slowly rock back and forth – whatever your predisposition may necessitate.
A study conducted in 2006 indicated that 1 in 4 Pakistanis was overweight and a 2014 global study on obesity ranked Pakistan 9th out of 188 countries. But it's hard to blame anyone. When I look around, I only want comfort food too
Economic wellbeing
To measure a nation’s economic wellbeing, it is suggested that various economic metrics be considered. In Pakistan we have experienced some persistent concerns for citizens. The Consumer Price Index rose from 2.1 to 150.8 during 1960 - 2016 according to the World Bank, an increase of 7253.7%. Inflation rose from 6.7 % to 20.3 %, an increase of 192.0% from 1960 to 2014 before it finally began to decrease. According to UNICEF the average inflation rate between 1990 and 2012 was 10.3% (double digit inflation is alarming by most standards). In the last fiscal year alone, the Pakistan Bureau of Statistics noted that prices for food and beverages increased by 3.3% while other daily needs like water, electricity and gas went up by 4.9%.
The GINI index, determining income inequality, stood at 0.41 in 2013-14 according to the UNDP. One would naturally have trouble believing that the bottom 21% currently living below the poverty line, struggling to make ends meet at PKR 158.1 or USD 1.25 per day is a group of happy, satisfied individuals.
Environmental wellbeing
The health of the environment around a person is correlated to peace, harmony and, of course, happiness. Consequently, this indicator is measured along metrics like pollution, noise and traffic. Unfortunately, Pakistan’s environment is not faring so well. CO2 emissions stood at 0.896 metric tons per capita in 2014 (not surprising as 67.7% of our energy comes from fossil fuels). Forests are also disappearing at a rate of 2.1%. Another telling factor in the overall environmental wellness pertains to noise pollution. The WHO recommends safe levels of 45db, 55db and 65db for residential, commercial and industrial areas respectively while studies indicate that levels of noise above 80db can“increase aggressive behavior”. Despite this, Pakistan’s National Environmental Quality standards (NEQS) allow for up to 85db of noise from vehicles. A report from the Pakistan Environmental Protection Agency (PEPA) notes that averages in major cities are higher than the internationally recommended amounts, with 76.5 db recorded in Karachi and 72.5 db in Islamabad, Rawalpindi and Gujranwala. The most alarming levels were reported in Peshawar where the average was a shocking 86db with a maximum 708.5db throughout the day.
Physical wellness
With 0.81 physicians, 0.6 nurses and midwives, 0.1 community workers and 0.6 hospitalbeds available per 1,000 people, not much physical wellness can be expected from a nation. Compounding this problem, healthcare and medication prices increased by 10.5%and 14.0% respectively last year. Awareness and access to balanced, healthy nutrition – a major factor in physical and mental health – is also a problem here. A study conducted in 2006 indicated that 1 in 4 Pakistanis was overweight and a 2014 global study on obesity ranked Pakistan 9th out of 188 countries. But it’s hard to blame anyone. When I look around, I only want comfort food too.
How we believe that public health expenditure at a mere 0.9% of GDP is sufficient to rectify this sad state of affairs is beyond rational analysis (keeping in mind of course that this is the same country where the military expenditure was 3.6% of GDP in 2016).
Rates of depression are reported to be very dangerously high in Pakistan
Mental wellbeing
Something to ponder on is that 34% of our population is suffering from depression according to the Pakistan Medical Association (PMA) when the global average stands at 20%. The PMA also estimates that 35.7% people in Karachi, 43% in Quetta and 53.4% in Lahore were affected with mental illness in 2017. Pakistan Association for Mental Health (PAMH) contends that 25% of the households in the country have someone who is currently suffering from depression.A report by the Network for Consumer Protection also indicates that the sales of antidepressants in the country were a whopping PKR 821.17 million, tranquillisers and hypnotics were 1.36 billion and antipsychotics 377.02 million in 2006. It is also no surprise that the Global Adult Tobacco Survey found that 19.1% (31.8% men and 5.8%women) of our population are smoking. Not quite the signs of happy, healthy people.
Support, of course, is hard to find in a country where the ratio of psychiatrists is 0.31 for every 100,000 people according to the WHO (the recommended amount by contrast is 1: 25,000 according to the Royal College of Psychiatrists, UK). This grim picture of mental health is corroborated by crude suicide rates of 2.5/100,000 people (WHO), bearing in mind that suicide is considered a mortal sin, the unreported number is probably higher.
Workplace wellbeing
Labour metrics such as jobless claims, workplace complaints and lawsuits are considered for this indicator. The Pakistan Bureau of Statistics reports unemployment at 5.96 %. However, this figure may be considerably higher given that in Pakistan the measurement of unemployment is not based on any methodology. The basis for government estimates is not available – researchers quote from various sources and figures of unemployment continue to vary. A telling story, however, is that last week a board member of a regulatory body informed me that for one mid-level job advertised recently, they received 1,621 applications, many of whom were completely over-qualified. Numbers on workplace complaints are hard to find as we have only just enacted laws on workplace harassment in 2010. So essentially, for almost the first 60 years of our existence, workers were protected by nothing and had no recourse in case of mistreatment or harassment in the workplace. One can be certain that pent up anger and frustration over workplace conditions can’t be very conducive to the health of a nation.
Social wellness
Suggested indicators here include safety, divorce rates, complaints of domestic conflicts and lawsuits. I fear for the social wellness component of people living in a country where the number of recorded incidents of crime against person in 2010 was 92,279 – displaying an increase of 43.8 % from the 2000 figure according to the UN Office on Drugs and Crime. Divorce rates are being described as accelerating by people due to the breakdown in traditional systems. In the city of Lahore alone, more than “100 divorces were registered in family courts in a day” in 2011. Domestic disputes, of course, are a rarely reported phenomenon due to the patriarchal culture of the country, though the more extreme cases like acid attacks (reported to be over 200 per year) hint at the level of social wellness that women are currently experiencing here. The fact that we had to have an “Acid Control and Acid Crime Prevention Bill” enacted in 2010 is fairly ludicrous – it would seem like it was considered legal to burn someone with acid prior to 2010!
Political wellbeing
Some of the suggested indicators for political wellness are the quality of local democracy, individual freedom and foreign conflicts. Pakistan on a democratic level is a country which has seen 45.3% voter turnout on average, according to NADRA and the ECP. By comparison it was 87.2%, 82.6% and 77.9% in the top three countries ranked by PEW research (Belgium, Sweden and South Korea respectively). The feudal/ tribal nature of the rural society also probably ensures that most of the votes are decided by the landowners or tribal chieftains anyway. A telling gauge of our individual freedom could be that the World Bank ranks the strength of legal rights in the country as a 3 (0=weak to 12=strong). Additionally, several India-Pakistan wars, the 1971 war in Bangladesh, the Siachen conflict, Kargil war and the Kashmir dispute are just some of the foreign conflicts that the country has been involved in.
I find this quick snapshot quite disturbing with every indicator seemingly in the red zone. We are obviously a nation living with the bare minimum of satisfaction in every sense and it is no wonder most people resort to violence in the streets at the drop of a pagri. Me,I’m going to utilise all three aforementioned options after this painful exercise. I have a cup of tea, a bowl of ice-cream and am indeed rocking slowly back and forth.
(All figures courtesy of World Bank Metadata unless specified otherwise)
