The Sham Doctors Who Prey On Pakistan's Poor

Street scene near Rawalpindi, Pakistan
Street scene near Rawalpindi, Pakistan
Malik Ayub Sumbal

RAWALPINDI — When 40-year-old government employee Danial Ahmed has problems with his teeth, he goes to a quack on the streets of Rawalpindi, Pakistan. “The price of dental treatment is expensive,” he says. “I cannot afford it. These quacks offer cheap treatment. For just a few hundred rupees, we can get relief from toothache and other oral infections.”

These cheap alternatives to real doctors can easily be found on virtually any roadside in Pakistan. They sit along the streets or in a small kiosks, where patients are treated on the spot.

According to the government, there are more than 600,000 of such sham doctors practising across Pakistan. They claim they can treat anything from minor dental problems to deadly diseases, and they’re obviously offering their services without authorized medical degrees.

Many poor people prefer going to them than to real doctors, as private medical practices and legitimate clinics charge what for them is too hefty a sum.

Ahmed Khan, 50, is sitting on the pavement in Rawalpindi’s busiest square. He has been treating patients here for the last two decades. He’s well known among his clients — two to three dozen visit him every day — for treating everything from headaches to dental problems.

“I’m experienced in doing this job,” he says. “I have treated hundreds of patients each day. The majority of them get relief after my treatment. Otherwise, why would they visit me?”

Most of his patients are from poor families and cannot afford anything else. Khan and others like him charge as little as $1 dollar and provide cheap medicine.

Dr. Muhammad Nawaz Khokar is among those who are concerned about the practice. “They’re playing with the lives of innocent people,” he says. “And they have no expertise in diseases. They use unsterilized equipment, which is a major reason for the spread of diseases from one patient to another. This is how the majority of diseases are being transmitted in Pakistan.”

In 2009, the Supreme Court ordered health secretaries to take action against quackery, but so far nothing has happened. A year later, the government passed the Health Care Commission Act and asked all local authorities to end quackery in their districts. But many of them operate in rural areas that have limited medical facilities.

“We have started to crack down against them, but they have strong backing,” says Dr. A.K. Niazi, head of the Rawalpindi District Health Office. “There’s a law against quacks, but it’s not implemented. According to the law, quacks should be put behind bars and are not eligible for bail.”

In fact, dozens of illegal clinics have been closed down. But examples of these fake doctors going to jail because of what they’re doing are still very rare.

Muhammad Qasim Khan, 45, still regrets his decision to visit one of these unqualified people for his illness. “I went to a quack near my house for medication for my fever,” he recalls. “But he injected me with something, and now I’ve been infected with hepatitis. I’m now undergoing treatment for this fatal disease. It’s been a lesson for me — never ever go to a quack. They can be deadly.”

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Iran-Saudi Arabia Rivalry May Be Set To Ease, Or Get Much Worse

The Saudis may be awaiting the outcome of Iran's nuclear talks with the West, to see whether Tehran will moderate its regional policies, or lash out like never before.

Military parade in Tehran, Iran, on Oct. 3


LONDON — The Iranian Foreign Ministry spokesman Saeed Khatibzadeh said earlier this month that Iranian and Saudi negotiators had so far had four rounds of "continuous" talks, though both sides had agreed to keep them private. The talks are to ease fraught relations between Iran's radical Shia regime and the Saudi kingdom, a key Western ally in the Middle East.

Iran's Foreign Minister Hossein Amirabdollahian has said that the talks were going in the right direction, while an Iranian trade official was recently hopeful these might even allow trade opportunities for Iranian businessmen in Saudi Arabia. As the broadcaster France 24 observed separately, it will take more than positive signals to heal a five-year-rift and decades of mutual suspicions.

Agence France-Presse news agency, meanwhile, has cited an unnamed French diplomat as saying that Saudi Arabia wants to end its costly discord with Tehran. The sides may already have agreed to reopen consular offices. For Saudi Arabia, the costs include its war on Iran-backed Houthis rebels fighting an UN-recognized government in next-door Yemen.

The role of the nuclear pact

Bilateral relations were severed in January 2016, after regime militiamen stormed the Saudi embassy in Tehran. Amirabdollahian was then the deputy foreign minister for Arab affairs. In 2019, he told the website Iranian Diplomacy that Saudi Arabia had taken measures vis-a-vis Iran's nuclear pact with the world powers.

It's unlikely Ali Khamenei will tolerate the Saudi kingdom's rising power in the region.

He said "the Saudis' insane conduct toward [the pact] led them to conclude that they must prevent [its implementation] in a peaceful environment ... I think the Saudis are quite deluded, and their delusion consists in thinking that Trump is an opportunity for them to place themselves on the path of conflict with the Islamic Republic while relying on Trump." He meant the administration led by the U.S. President Donald J.Trump, which was hostile to Iran's regime. This, he said, "is not how we view Saudi Arabia. I think Yemen should have been a big lesson for the Saudis."

The minister was effectively admitting the Houthis were the Islamic Republic's tool for getting back at Saudi Arabia.

Yet in the past two years, both sides have taken steps to improve relations, without firm results as yet. Nor is the situation likely to change this time.

Photo of Iranian Supreme Leader Ali Khamenei in 2020

Iranian Supreme Leader Ali Khamenei in 2020

Riyadh's warming relations with Israel

Iran's former ambassador in Lebanon, Ahmad Dastmalchian, told the ILNA news agency in Tehran that Saudi Arabia is doing Israel's bidding in the region, and has "entrusted its national security, and life and death to Tel Aviv." Riyadh, he said, had been financing a good many "security and political projects in the region," or acting as a "logistical supplier."

The United States, said Dastmalchian, has "in turn tried to provide intelligence and security backing, while Israel has simply followed its own interests in all this."

Furthermore, it seems unlikely Iran's Supreme Leader Ali Khamenei will tolerate, even in this weak period of his leadership, the kingdom's rising power in the region and beyond, and especially its financial clout. He is usually disparaging when he speaks of Riyadh's princely rulers. In 2017, he compared them to "dairy cows," saying, "the idiots think that by giving money and aid, they can attract the goodwill of Islam's enemies."

Iranian regime officials are hopeful of moving toward better diplomatic ties and a reopening of embassies. Yet the balance of power between the sides began to change in Riyadh's favor years ago. For the kingdom's power has shifted from relying mostly on arms, to economic and political clout. The countries might have had peaceful relations before in considerably quieter, and more equitable, conditions than today's acute clash of interests.

For if nuclear talks break down, Iran's regime may become more aggressive.

Beyond this, the Abraham Accord or reconciliation of Arab states and Israel has been possible thanks to the green light that the Saudis gave their regional partners, and it is a considerable political and ideological defeat for the Islamic Republic.

Assuming all Houthis follow Tehran's instructions — and they may not — improved ties may curb attacks on Saudi interests and aid its economy. Tehran will also benefit from no longer having to support them. Unlike Iran's regime, the Saudis are not pressed for cash or resources and could even offer the Houthis a better deal. Presently, they may consider it more convenient to keep the softer approach toward Tehran.

For if nuclear talks with the West break down, Iran's regime may become more aggressive, and as experience has shown, tensions often prompt a renewal of missile or drone attacks on the Saudis, on tankers and on foreign shipping. Riyadh must have a way of keeping the Tehran regime quiet, in a distinctly unquiet time.

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