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Pakistan’s insecure N-assets
Global community must shed its inertia
by Rajiv Nayan
On January 1 this year, as part of their agreement, India and Pakistan exchanged the lists of their nuclear facilities — an annual exercise going on for some time. Before that, the two countries held a meeting to discuss conventional and nuclear confidence-building measures (CBMs). A section of the media reported that among other issues, the two neighbours discussed the possibility of cooperation on nuclear safety. This could be an issue for the countries which are running nuclear facilities, but for Pakistan, nuclear safety is a marginal issue. What is the real nuclear issue in Pakistan? The real issue is the security of the Pakistani nuclear assets. These assets are in both military and civil nuclear energy sectors. The international community is talking about ‘fatwa for fissions’. The Pakistani nuclear establishment is expanding its arsenals. The plutonium route has seemingly been added to the existing enriched uranium route. Pakistan is adding facilities for reprocessing and spent fuel generation. The increase of the Pakistani nuclear stockpile is making the international community anxious. Time and again, official statements from different countries come and reports of different academic centres underscore that Pakistan’s nuclear arsenals are under danger. Some believe and express that Al-Qaida operatives may lay their hands on Pakistan’s nuclear weapons. As the world is reluctant to believe that the Pakistan authorities did not know about the presence of Osama in Pakistan, it is also not ready to accept that Pakistani nuclear scientists and its army, which is really controlling nuclear weapons, had no connection with Osama’s terror network. A section of the international community does point to the complicity of a section of the Pakistani atomic establishment. For more than a decade, reports are coming about the association of Pakistani scientists and a section of the army with jihadis. Some sympathetic Western writings have also acknowledged that the physics departments and the army of Pakistan are infected. However, the pre-dominant reaction in the international community after Operation Geronimo is that Pakistan is worrying only about the security of its nuclear arsenals assuming that the Pakistani nuclear establishment would not cooperate with Al-Qaida. It just asks some explanation about the security of its nuclear weapons and materials. One of the US Senators, Robert Casey, said that the entire Osama episode demonstrates an “apparent incompetence” of the Pakistan government. He also said that it “does not inspire confidence in the ability of Pakistan’s governing or security institutions to oversee their nuclear weapons programme.” The same thinking is emanating from the academic community. A Harvard University scholar, Olli Heinonen, who earlier worked for the International Atomic Energy Agency and with A. Q. Khan and the Pakistani proliferation network for long, gave a statement: “There is very little assurance that nuclear materials and facilities are fully under (Pakistani) government control.” He advocated technology and security assurance to Pakistan but wanted Islamabad to “stop production of fissile material for military purposes, commit to a moratorium on nuclear testing and provide full disclosure of nuclear proliferation activities involving Iran, Libya, North Korea and Syria.” Pakistani nuclear warheads are dispersed so that any Indian attack does not destroy the complete stockpile. Some reports denote that Pakistani warheads are stored deep inside the country to escape any attack. The Osama episode clearly shows that Al-Qaida can reach everywhere, even deep inside the country. The dispersed nuclear arsenals are not only vulnerable to falling in wrong hands but also making the gathering of intelligence a complicated affair for the US. Even the supporters of the idea that the Pakistani nuclear stockpile is well protected by the professional Pakistan Army would admit the possibility of Al-Qaida infiltration at the mid-level. Corruption is yet another channel of terrorists’ entry into Pakistan’s nuclear storage. Nuclear materials may be another weak area. The uranium mine at Dera Ghazi Khan has been closed down and other such mines are in jihadi-dominated areas. More importantly, questions about the security of the Pakistani nuclear assets were raised by the country’s former Foreign Minister Shah Mehmood Qureshi also. Encouraged by Operation Geronimo, some analysts in the US are exploring the possibility of ‘snatch and run’ operation for Pakistani nuclear weapons. Some informal briefings from the defence department indicate that the Pentagon has a plan to undertake this kind of an exercise. It seems the US is not undertaking this exercise because it may not have complete intelligence, though it is being hinted that it may go in for this course in the event of ‘extremists’ coup’. What the US and the world should do is to come out of inertia, which allowed Osama to live in Pakistan and the Al-Qaida network to operate from the Pakistani soil. The repeated solution in technological, security and financial assistance would not improve the situation as the Osama case demonstrates. Instead, it would further complicate the matter. Pakistan will continue to blackmail the world. The unorthodox US approach demonstrated in capturing Osama should be extended to the nuclear realm as well. The US needs to wake up and act. So does India. Admittedly, in the last couple of years, the Indian government along with its strategic community has begun to talk about the global danger posed by the Pakistani nuclear weapons stockpile. India may have to go beyond that. The international community is cognizant of the danger from the Pakistan nuclear stockpile. India has to keep it alerted. New Delhi may also have to sharpen its diplomatic skills and reach out to the countries which are still hesitant to take on Pakistan. In international forums, India should side with the Western world to ensure the security of the Pakistani nuclear assets. Apparently, China is scuttling the move to target Pakistan on nuclear security matters. The Nuclear Security Summit Process is active, and the second summit will take place in Seoul on March 26-27. The IAEA has also developed plans for nuclear security. Both forums are engaging Pakistan, though no one is sure of the efficacy of the two systems. India should not become a captive to its largely archaic Non-Aligned Movement (NAM) philosophy and allow the bailout for Pakistan. During the Washington NSS, India announced the setting up of a global centre of excellence — the Global Center for Nuclear Energy Partnership. India should take the opportunity and showcase the global centre and engage Pakistan in it as well. However, it should continue to search for a new and innovative mechanism in cooperation with the concerned members of the international community to secure Pakistan’s nuclear
assets. The writer is Senior Research Associate, Institute for Defence Studies and Analyses, New Delhi.
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The optical illusion
by Harish Dhillon
People who know me know that I have a fetish for short hair. Maybe, it is a hangover from my schooldays when the military heritage of the school was so strong that short hair was a must and your house lost points for the cock house if you allowed your hair to grow over the prescribed length. Perhaps it is because a crew cut was absolutely mandatory during my training for the army. Perhaps it is a bit of both. But the net result is that the moment my hair grows longer than a crew cut I begin to feel very uncomfortable. So, it is that even in retirement, once a week, I make my way to the little kiosk which serves as a hair-dressing saloon and Rajinder dutifully runs the machine over my scalp to give me the shortest and quickest haircut possible. I must, over this last one and a half years, have become his most regular customer and I am, as a result, given special treatment like out of turn attention and the odd cup of tea. Three weeks ago this special treatment took the form of a new piece of cloth, which Rajinder pulled out with a flourish from its packing and wrapped around my shoulders. The front of the cloth had a screen printed picture of an extremely attractive young female, wearing an extremely low-cut blouse. As I admired the reflection of this image in the mirror opposite me, I had the weird impression that her bosom was heaving. It was a life time since anyone’s bosom had heaved for me and though I felt a thrill of excitement, I was also acutely embarrassed. I looked quickly away, wondering if anyone else had also noticed this strange phenomenon. When Rajinder turned to plug in the machine I looked quickly down at the young woman. Yes, what I had imagined was indeed happening, but it was a mere optical illusion — a response my own heavy breathing. I could not help laughing at myself: at my age I could not have hoped for anything other than optical illusions. I walked out of the kiosk with a spring in my step and a song in my heart. Even the optical illusion, by its very nature, had left me lighter in heart. I waited out the week impatiently. Sometimes I considered going back to Rajinder even before the week was out but then realised that he would see through my motive and regard me as yet another dirty old man. Finally, the week did come to an end. I found myself sitting in Rajinder’s chair with impatient anticipation. Deep was my disappointment when Rajinder took out another new piece of cloth and wrapped it around my shoulders — you see it had sunflowers printed all over it. I realised that I couldn’t even be sure of optical illusions anymore and would have to be content with the mere memory of optical
illusions.
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The ongoing cervical cancer prevention week (January 22-28) has once again put focus on this dreaded disease. Most sexually
active women are at risk of contracting this disease but the risk factors are higher in the 40-plus age group. However, a simple Pap smear test can help detect this malady. It can be fully cured, if discovered at a pre-cancerous stage
Surviving cervical cancer
Dr Anshuman Kumar
 After
breast cancer, cervical
cancer is the second leading cause of cancer-related deaths among
women in India. Call it ignorance, or an unfounded optimism; most
women in our country do not acknowledge a disease till such time they
are diagnosed with it. As a result, many women remain unaware that
they stand a risk of developing cervical cancer the most.Cervical cancer, the cancer of the mouth of the uterus called the cervix, is the most common type of cancer in India. Almost all sexually active women are at the risk of contracting the disease. But the risk factors are higher in the 40-plus age group. According to a recent study by the World Health Organisation, every year 1,32,082 women are diagnosed with this cancer in India and 74,118 die from the disease. Detecting the disease at a pre-cancerous stage can cure this cancer completely. Though abnormal cervical cell changes rarely cause symptoms but if these cell changes grow into cervical cancer, they show some basic symptoms.  Symptoms like bleeding from the vagina that does not seem normal or if there is a change in the menstrual cycle or if they bleed during sex or when the cervix comes in contact with any object should be taken seriously. Abnormal bleeding is the first sign that should alert a woman that something is not right.
Other symptoms like pelvic pain or pain during intercourse, vaginal discharge that is tinged with blood, too, should not be ignored. Cervical cancer begins with the development of pre-cancerous, benign lesions in the cervicular area. The first stage of development is mild dysplasia, which can then progress to moderate dysplasia, severe dysplasia, and then carcinoma in situ (CIS) or invasive cervical cancer. With progressing age, this cancer seems to get more pronounced, which is due to the simple reason that after women reach menopause, most of them think that there is no more need for a Pap smear test. If most women undergo this simple test annually more than 70,000 lives can saved every year. A major risk factor for the development of cervical cancer is human papilloma virus (HPV) infection. The DNA of HPV has been found in almost all cases of invasive cervical cancer. HPV is a sexually transmitted infection, making cervical cancer a chronic disease with an infectious aetiology. The primary reason for the rise in the number of cases is the lack of access to screening and health services, and also lack of awareness of the risk factors of cervical cancer. HPV infection and pre-cancerous lesions go unnoticed and develop into full-blown cancer before women realise they need medical help. The disease can be prevented through HPV vaccines, regular Pap smear testing and the cervical cancer vaccine. The cervical cancer vaccine is the first vaccine ever designed to prevent cancer. It is recommended for pre-teen girls aged 11 to 12 years, as it allows a girl's immune system to be activated before she is likely to encounter HPV. The other aspects, which cannot be ignored, are delayed sex, personal hygiene and use of condoms. Delayed sex can help in reducing or avoiding HPV. It also helps to limit your number of sexual partners, and to avoid having sex with someone, who has had many other sexual partners. Personal hygiene is an important factor that every woman needs to take utmost care of, especially women who are into a profession where they may have multiple sex partners, they need to stay clean and healthy all the time to reduce the chances of cervical cancer. Condoms, when used correctly, can lower the HPV infection rate by about 70 per cent. The use of condoms can't give complete protection because condoms do not cover every possible HPV-infected area of the body, such as the skin of the genital or the anal area.
Preventive testsThere are three important tests recommended by the doctors — Pap smear test, HVP test and colposcopy test. In Pap smear test, cells are collected from the surface of the cervix and checked on a slide. This test is available in most hospitals and clinics. Its cost varies from Rs 250 to Rs 500. In HPV test, doctors take DNA cells by swabbing the cervix. It is ideal for the detection of cervical cancer. It is slightly more accurate than the Pap smear test. This test is available in all major hospitals and costs around Rs 1,500. In colposcopy test, the image of the cervic is enlarged and the cells can be seen clearly. It is available at all major hospitals in India.
TreatmentThe three main treatments available today are surgery, radiotherapy and chemotherapy. In cases of surgery, lymph nodes, uterus and, at times, some parts of the vagina are removed. After this surgery, chances of a woman conceiving later in life are nil. Medical researchers state a few do's and don'ts for the patients of cervical cancer. It is not advisable to have sex at an early age, having multiple sexual partners, multiple pregnancies, using birth control pills for five or more than five years. It is also suggested not to consume any form of tobacco. Every woman should undergo an yearly Pap smear test after she turns 35. Parents should opt for vaccination against HPV for every girl aged nine to 11 years. All of us underline the importance of women's health as the cornerstone of a healthy family. Women in India still don't have the right information about the disease. It is important to spread awareness and have the right knowledge about it. In Western countries, the cases of cervical cancer have come down due to awareness campaigns about the disease. Also, vaccines and tests are available in the West, which check or detect the cancer at an early age. If adopting these measures can bring down the number of cervical cancer cases then each one of us should also adopt these so as to save valuable lives. The writer is senior oncosurgeon at Dharamshila Cancer Hospital and Research Centre, New Delhi
Checks and balancesUnhygienic practices and multiple-sexual partners are the most common cause behind cervical cancer. A recent survey states that nearly 12 per cent of women, who use sanitary napkins, are at a lesser risk of this disease than the women who don’t. Unhygienic sanitary practices can lead to infections in the urinary tract, resulting in cervical cancer. The countrywide survey, conducted by AC Nielson and NGO Plan India, also showed that the reproductive tract infection (RTI) incidence was 70 per cent more common among the women with unhygienic sanitary practices. Sanitary napkins in rural areas are hardly used and women are totally unaware of the hygiene practices, which increase the rate of cervical cancers and RTIs. The biggest barrier in the adoption of quality sanitary napkins in India is that nearly 70 per cent of women and their families cannot afford sanitary napkins. The study stated that more than 88 per cent of women resort to shocking alternatives such as cloth, ashes and husk sand during menstruation, thereby causing severe reproductive health problems. The study also revealed the dismal state of feminine hygiene in India. Apart from smoking and papilloma virus, dietary factors, multiple pregnancies, hormonal contraception, family history of cervical cancer, HIV infection, and taking hormonal drugs can also lead to cervical cancer. India has one-fourth of the world's burden of cancer of the cervix with nearly 132,000 women being diagnosed with it annually.
Cervical cancer policy in IndiaThe Policy and Programme for Cancer Control and Prevention India has a National Cancer Control Programme (NCCP), which was established in 1975-76. It was revised a decade later. There are five schemes under this programme, namely, the recognition of new regional cancer centres (RCCs), the improvement of existing RCCs, development of oncology wings in government medical colleges and hospitals, the running of the district cancer control programme, and the establishment of a decentralised NGO scheme, under which NGOs are to be provided with grants for conducting IEC activities (National Cancer Control Programme). Despite this, however, there is a substantial shortage of cancer treatment facilities in the country.
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