Invisible People, Visible Barriers
19 vaccinations.39 The Government has made no effort to spread awareness or
conduct testing for COVID-19 in these areas.40 Most people’s first exposure to
information about COVID-19 is through WhatsApp and the stories on it are often
rife with conspiracy theories and general misinformation.41
The problems in accessing healthcare go beyond COVID-19. Most of the
inhabitants of Machar Colony are fishermen or shrimp peelers.42 Their livelihoods
depend on seasonal, low-income jobs; they are unable to get other work due to the
lack of legal documents. Unsafe drinking water, lack of sewerage, improper waste
disposal in proximity to the settlement and lack of affordable healthcare providers
has resulted in many deaths from preventable diseases like dengue and the
chikungunya virus.43 For the residents of Machar Colony, healthcare is
unaffordable.44 In most cases, stateless people rely on each other by taking loans
from other members of the community to pay for healthcare. In Machar Colony,
the estimated cost of medical help from private health centres per visit is
PKR5,000 (about USD30);45 the estimate includes doctors’ fees and the cost of
medicine. For maternity care, costs are usually not incurred as most people choose
to deliver their babies at home without the presence of any medically trained
professionals. A delivery at a private hospital costs anywhere from PKR15,000 to
PKR30,000 (approximately USD85 to USD170).46 Public hospitals either turn the
pregnant mothers away due to lack of documentation or do not provide satisfactory
care and require the patient to bring someone to be with them at all times, which
is often not possible for these low-income working families. In consequence, most
people choose to give birth at home or go to untrained or unlicensed professionals,
which has led to the passing of many mothers and infants.47
DISCUSSION
The state’s insistence on maintaining that Bengalis are foreigners has affected
research and advocacy for this community. Academics are hesitant to conduct
39
40
41
42
43
44
45
46
47
Javed (n 8).
Haniya Javed, ‘How Worse Can Coronavirus Be for Us?’, Asia Democracy Chronicles
(online, 6 August 2021) <https://adnchronicles.org/2021/08/06/how-worse-can-corona-befor-us>, archived at <perma.cc/64WV-D2CH>.
‘Misinformation Mitigating Policies and Practices Compared: Lessons from South Africa’
(Research Brief, AHA! Awareness with Human Action, 2022) 3.
Shah (n 9); Gazdar (n 5) 163.
Raza (n 27) 30.
Xari Jaril, ‘50 Years of Statelessness: The Bengalis of Macchar Colony’, Voicepk (online, 26
December 2021) <https://voicepk.net/2021/12/50-years-of-statelessness-the-bengalis-ofmacchar-colony>, archived at <perma.cc/57B2-LTR3>.
Murad Moosa Khan, ‘Private Healthcare in Pakistan — Costly, Unregulated and Predatory’,
The Express Tribune (online, 18 November 2019) <https://tribune.com.pk/
article/90951/private-healthcare-in-pakistan-costly-unregulated-and-predatory>, archived at
<perma.cc/AGF7-JKK2>.
Hospital charges for delivery are listed in several not-for-profit hospitals in Karachi: see, eg,
‘Normal
Delivery’,
Indus
Hospital
&
Network
(Web
Page,
2022)
<https://indushospital.org.pk/donate/normal-delivery>, archived at <perma.cc/FQ4P-2U5G>;
‘How
You
Can
Help’,
Lady
Dufferin
Hospital
(Web
Page,
2020)
<https://www.ladydufferinhospital.org/how-to-help>, archived at <perma.cc/7RGK-VMVE>.
Nusrat Shah et al, ‘Home Deliveries: Reasons and Adverse Outcomes in Women Presenting
to a Tertiary Care Hospital’ (2010) 60(7) Journal of the Pakistan Medical Association 555,
556–58.
291