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Health of our leaders

Keeping in mind the impact our leaders’ health have on national issues, all persons contesting elections should be required to provide medical information

Health of our leaders

Donald J Trump, president of the United States, underwent his first ‘yearly’ medical examination by the official White House doctor and was pronounced to be in ‘excellent’ health. Yes, he is a trifle overweight and he does take a few medicines, to keep his blood cholesterol low and to keep his hair growing. Though independent cardiologists are a trifle worried about the high level of bad cholesterol in his blood in spite of taking a medicine for it.

He also underwent a test to measure his mental acuity. What that means is that he was tested to see if he was developing ‘dementia’. Fortunately or sadly depending on your point of view he is not demented. And from a medical point of view he needs to do a couple of things that almost all the people I know would also like to do, exercise more and eat less.

In Pakistan’s history, the health of Jinnah played an important role. Jinnah was most likely suffering from advanced tuberculosis (TB). Just compare his pictures from the middle nineteen forties and those around partition and you see a man who is quite unwell. He had obviously lost a lot of weight and looked sick.

The second suggestion I have is that just as all persons contesting elections have to provide financial information, they should also be required to provide medical information.

Jinnah knew he was not well and that surely had an influence on his political decisions about the timing of the partition. Of course if Jinnah was healthy things might have been different even during the early years of Pakistan. But his early death definitely set Pakistan on an unfortunate path from which it has not completely recovered even now.

Also, the post stroke dementia suffered by Ghulam Muhammad, the third governor general (GG) of Pakistan, is well known. It eventually forced Iskander Mirza to replace him and take over as GG. If Ghulam Muhammad was not sick and if Iskander Mirza did not replace him, would there have been a 1958 martial law? So, health of our leaders is an important issue.

Over the last few decades the US political system sort of expects information about presidential candidates and their state of physical health. The information is usually available from personal physicians and can be limited. However once in office, much of the medical information about a president becomes available to the public. I have in the past wondered whether we should have a similar system available in Pakistan.

Recently in Pakistan the health of our leaders became of some importance. Asif Zardari as president might have suffered a small stroke. At the time that happened there was no official word on what exactly happened and he was rushed off abroad for tests and treatment. Fortunately, he recovered completely. During the absence or incapacity of the president a mechanism exists that allows the chairman of the Senate to take over.

More worrisome was the relatively recent illness of former prime minister, Nawaz Sharif. He reportedly underwent open heart surgery and was in England for more than a month and even after his return seemed a bit ‘off’ for a few more months. He has since recovered completely at least physically. But during his month long absence and the postoperative time, he remained PM and all his executive powers were essentially in the limbo or being exercised by close family members in his name.

As someone who has taken care of more than a few thousand post open heart patients, I can say that such surgery can produce lasting behavioral and mental changes. Whether Nawaz Sharif and his new aggressive persona is a result of that surgery is in my opinion an open question.

Shahbaz Sharif, Chief Minister of the Punjab and PM in waiting, also has a peculiar medical history. More than a decade ago, he reportedly underwent an appendix operation in Saudi Arabia where he was living in exile. During surgery he was found to have a ‘problem’ requiring permission for a trip to the US for further treatment. Information available in the US at that time suggested that Shahbaz Sharif had a ‘carcinoid tumour’ and underwent removal of a large part of his large intestine.

That Shahbaz Sharif had this problem was neither denied nor confirmed. By any estimation he is now ‘cured’ of that problem if he did have that to start with, but he does visit England for a routine checkup every year. Of course no information is ever provided to the public about the purpose or the results of these routine checkups. And yes, during his visits abroad the CM continues as CM and conducts official business while out of the country.

So I have a few suggestions. First, there should be a constitutional mechanism that another person should take over the function of the PM or the CM if they are out of the country or are sick for more than let us say forty eight hours. The simple solution is to have a deputy PM and a deputy CM as a constitutional position.

The second suggestion I have is that just as all persons contesting elections have to provide financial information, they should also be required to provide medical information. This should include stuff like having high blood pressure, diabetes, Hepatitis C, AIDS, thyroid problems, neurological problems, previous operations, hospitalisations, reasons for hospitalisation, inoculations and history of communicable diseases like measles and chicken pox. And of course a list of all medications being taken should also be provided.

I don’t think that having been sick or having a treatable problem should be a reason for disqualification but lying about it should. My readers might wonder why I included measles and chicken pox in this list. It would indeed be embarrassing for the PM to come down with measles. And those adults that have had chicken pox are susceptible to a rather painful and debilitating condition called ‘shingles’.

Unfortunately mental health problems have such a bad reputation that any person known to have a mental health problem would automatically become unable to hold a responsible political office. This holds irrespective of however treatable that condition might be.

The brouhaha about Imran Khan’s most recent marriage proposal is interesting. I strongly suggest that all applicants for elected office should, besides the usually provided information and the information I have mentioned above, also provide information about all marriages, divorces and present number of wives. Women of course only need to provide the name of the present spouse if any.

It is well known that many politicians don’t even own a home or any cars and yet live in palatial mansions and are driven around in luxury automobiles. These of course are held in the name of their spouses and as such must be included in available assets. Settlements made on divorced wives would also provide necessary financial information.

Imran Khan’s choice of wives gives us some idea about what sort of a person he would like to spend time with. Over the years, he has gone from flashy to sober and that says something about his emotional evolution. So, for those that have been married often and divorced often, the choice of spouses does provide an interesting peek into their minds.

Syed Mansoor Hussain

syed mansoor hussain
The author served as professor and chairman, department of cardiac surgery, King Edward Medical University.

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