Measure is unceasing

COVID-19 in rural Balochistan, Pakistan: Two interviews from May 2020

The interviews were carried out to better inform a team of forecasters and superforecasters working with an organization which was aiming to develop better COVID-19 forecasts early on in the pandemic for countries and regions which didn’t have the capability. Said team and I came up with the questions, and the interviews themselves were carried out in Urdu by Quratulain Zainab and then translated back to English.

Back then, I think these interviews were fairly valuable in terms of giving more information to our team. Now, more than two years later I’m getting around to sharing this post because it could help readers develop better models of the world, because it may have some relevance to some philosophical debates around altruism, and because of “draft amnesty day”.

Interview 1.

The conversation was with Najeeb from Loralai, Balochistan. This is a translation from Urdu. The translator, Quratulain, would like to specify that they don’t talk exactly like this. The interview was carried out on the 12th of May of 2020.

Q: Where are you from in Balochistan? City or village?

N: I’m from Balochistan’s Larolai district, it’s 5 km from the city

Q: Okay. In your area, how many people live in each house?

N: There’s a combined family system here. In each house, an average of 15-20 people. In some houses, up to 30-40. I told you the average.

Q: How much distance is there between each house?

N: There’s no distances. Attached houses.

Q: What do people there think about coronavirus? Are they worried about it or not so much? What do you yourself think about it?

N: Our city is almost Balochistan’s second largest city. Over here, 90% of people don’t accept that coronavirus could even affect them. Some say that yes, coronavirus exists on a world level but not in our city. There’s no case yet in our city.

Q: Yes, okay. Is there anything being done there to increase social distancing or sanitation?

N: Government tries it but the public gives no response. Government is tired.

Q: Ok. What things did the government try to do?

N: To make shutdown better, the government has tried a lot. Often shops have circles for distance, there’s printed material and wall chalking for awareness

Q: Meaning of wall chalking?

N: In villages, spreading awareness about precautionary measures against coronavirus

Q: Do shops and people follow this? And how strict is the government / police on this? Ok. How do you know about the villages?

N: \[They are strict\] to a large extent. I myself live in a village.

Q: Oh. You live in a village?

N: Yes

Q: So people are still following the rules?

N: Right now, before 5 pm there’s complete freedom. After 5 pm, the government forces all shops to close. For the rest of the village, there’s complete freedom. Because over here, there’s no patient yet so people don’t take it that seriously

Q: In people’s opinion, should there be more freedom? Before 5 PM all shops are open and after 5 PM all shops are closed?

N: People say that no one has been affected by it yet so why should there be such strictness. Yes.

Q: In the shops, are people close together or are they maintaining social distance because of the circles?

N: They are close together

Q: But they can’t go to shops after 5 pm? But they can meet their friends outside?

N: Yes. Only shops are closed. Otherwise, they can meet.

Q: Over the previous weeks, did you have any interaction with the medical system?

N: Yes I went \[to a hospital\]. CMH. 4 times in a week

Q: For what reason, if you want to say?

N: My nephew was ill. I took him there.

Q: What do you think about the hospitals there?

N: You must already know about CMH. 100 (emoji) was ok.

Q: What type of illness \[about the nephew\]

N: very severe fever. For many years. Even last year, and this year. So I took him for a check up.

Q: Is he fine now?

N: yes, yes

Q: ok

N: yes

Q: Are tests being conducted there for coronavirus in hospitals?

N: Sorry! I don’t know. Maybe they are happening but not confirmed

Q: Ok

N: Yes

Q: So if someone is afraid that they have the virus, what would they do?

N: For them, there are preparations done by hospitals. They’ll be isolated. Then a test will be done. Government has made isolation wards. In civil hospital

Q: In your opinion, hospitals / government are able to handle the isolation well?

N: Yes. Because if in the houses, someone gets the virus, then they can’t provide better isolation. So in my opinion, the hospital will be better.

Q: In your opinion, do the hospitals have enough masks / tests etc to deal with this situation?

N: Yes

Q: Okay. In your area, did you hear of any unexplained sickness or death? Do you know of anyone who might have covid?

N: No. No deaths in the city. I don’t know anyone personally who has the virus.

Q: Ok. Are mosques open there?

N: 100 (emoji)

Q: If they are open, how often do people go?

N: it’s pretty obvious 5 times \[a day\]

Q: In your opinion, should they remain open?

N: In my opinion, not in the city. But they should definitely be open in the villages. Because in villages, no one comes from outside. In the city, people come from different areas

Q: Ok. No one comes from outside to your village?

N: Very few people come from outside the village

Q: But visitors from outside do come?

N: Yes

Q: Ok. In one mosque, at one time (like for Friday prayers), how many people gather?

N: Other than Friday prayer, on average 25-30 people. For Friday prayers, more than 150

Q: And this is without distancing?

N: Yes

Q: What do people there think about how to treat covid cases?

N: There’s no treatment

Q: What do people think about how to deal with covid cases? Are there any superstitions about this?

N: Sorry I don’t know about this, what people think.

Q: Ok, no problem. What do you think about it?

N: Isolate them, provide a clean environment, give them the medicine etc, with time it will get better

Q: Ok. Do people there wear masks? Are there any laws about this?

N: In government offices, people wear masks. Otherwise, 80% of public doesn’t

Q: People can buy masks in shops?

N: Yes, they are available in pharmacies

Q: Do people make masks at home? Have you yourself made / worn a mask?

N: \[about making masks at home\] there was no need

Q: Ok

N: I wear a mask. Haven’t made it myself.

Q: Can people buy masks at a reasonable price at the pharmacy?

N: Yes

Q: Have people’s jobs been affected because of shutdowns due to the virus?

N: Labourers have been affected

Q: What do they do now?

N: Now, they go to work. Before, people helped them.

Q: In the city? But in your opinion, people have been largely unaffected financially?

N: Yes.

Q: What do you think about the Baloch nationalists?

N: I don’t know about this. In our area, there’s no such thing. Only pashtuns live here.

Q: Ok. In your opinion, how well is Pakistani government handling the covid situation?

N: Yes, they’re doing well. To a large extent.

Q: The Balochistan government as well?

N: Yes

Q: What do you think about the quality of CMH hospital?

N: Very satisfied

Q: If the virus spread a lot more, do you think the government would still be able to handle it well?

N: yes, when the public supports the government

Q: Ok. What do you think the chances are of you or your close relatives getting coronavirus this year?

N: Very little. This is my opinion but Allah knows best. I’m not giving a governmental report, all of this is just my opinion

Q: of course

N: I can be 100% wrong or 100% correct so it is not official

Q: Okay. Do you have any other thoughts on the topic?

N: No, this was it

Q: Okay. Thank you so much for taking the time to answer these questions. Thanks!

N: No problem. Thank Usman bhai \[friend/bro of Usman\]

Q: Bye

N: Bye

Interview 2.

The person interviewed is the Makran division head for a non-profit that operates nationally, providing supplies of food all over the country to people whose livelihoods have been affected due to COVID-19. He lives in Turbat, Makran in Balochistan. The interview was carried out on the 18th of May of 2020.

Q: What type of area do you live in? Is it a city or a village?

M: I live in a city but otherwise my connection is to the rural area Dasht.

Q: In your area, how many people live in one house?

M: Minimum five and many have a joint family system as well. From 10-12 people.

Q: What do people there think of coronavirus? Do they worry about it a lot or not so much? What do you yourself think about it?

M: People are very worried about this virus. People’s daily lives are greatly affected. Shops and markets are closed. The economic condition of the people is ruined. The government has turned lockdown into smart lockdown. But it is not being implemented by the public. Because the government is not helping the people. In Balochistan, there is no test facility in any city except Quetta. So far some cases have been reported in Makran, Gwadar and Panjgur. No cases have been reported in Turbat division.

Q: Is there anything being done there to increase social distancing and sanitation?

M: No.

Q: Are markets open? How crowded are they? Where do people buy food?

M: The shops are mostly all open here. People do not maintain distancing in the market.

The shops are closed now after 5 o'clock so there is a lot of crowding before

Q: Have you visited a hospital in the past few weeks or have any interaction with the medical system or with doctors?

M: Yes, I went to the hospital. I am in constant contact with doctors every day.

Q: What is your opinion of the healthcare system? Are there tests happening in your area for covid?

M: Doctors aren’t doing their duty in government hospitals but private clinics are quite crowded.

No, there is no test laboratory or facility.

Q: How often do people get fevers? When was the last time you or a friend had a fever? Do you know the reason for that fever?

M: I had a fever before Ramadan and recovered in a couple of days. I only took Panadol

Q: Have you heard of any unexplained illnesses or deaths in your area? Do you know of anyone who you think might have covid-19?

M: No, this has not happened in our area yet. There isn’t any facility for testing so who knows, someone might have coronavirus.

Q: Are mosques open there? What do people think about whether the mosques should be open? If the government tries to close mosques, what do you think will happen?

M: Mosques were closed in the beginning but are now open. People here are against closing mosques

Q: At one time, how many people gather in a mosque?

M: On Fridays the mosques are packed and the rest of the time there are are two to four rows

Q: Is there any local knowledge about how to deal with covid cases? Are there any superstitions about this?

M: People are self-quarantining. People who are less educated are more worried about this virus. However, educated people are not bothered by this, they just follow the instructions of the doctors

Q: Do people wear masks there? Are there any laws for this? Are people making masks at home? Have you yourself made or worn a mask?

M: Yes, they do. I wear masks too. People have made their own masks as well. I haven’t made my own. The Balochistan government has prohibited people from going out without wearing a mask.

Q: Are the people who go out without a mask fined or punished in some way?

M: No, this doesn’t happen.

Q: Are people meeting with their friends outside? Or having iftar at home with their friends? Do you think people will gather with their relatives and friends during Eid? By your estimate, what percentage of people wear masks outside?

M: Yes, definitely we meet our friends every day. Iftar gatherings have also been happening. I have been breaking my fast with a friend every day since Ramadan started. The situation here is that people will gather \[for Eid\]. 20% of people \[wear masks\]. There have been many funerals during this time and hundreds of people have attended. Due to corona, religious tendencies have increased. People have started going to mosques more.

Q: Why so many funerals? Are people falling more ill during this time?

M: No, because of old age. This is a picture of an iftar today, only two people are wearing masks. \[Attached was a photo of 13 men sitting close together, two wearing masks but these weren’t covering their mouth or nose so that they could talk\]

Q: What type of sickness in old age, if you know?

M: Diabetes, cancer, kidney, liver etc. Tuberculosis. There are no health facilities in Makran at all. Karachi is beyond the reach of the people

Q: Do any of them require a ventilator?

M: They do but ventilators are not available in Makran. If necessary, doctors refer the patient to Karachi. Due to lack of facilities, most patients die on the way. Makran does not yet have a good ambulance service, either provided by government or private service.

Q: Is the number of deaths now greater than, less than or the same as before?

M: Same as before, there has been no significant increase or decrease in our areas.

Q: Have people’s jobs been affected due to the virus and the lockdowns?

M: Government jobs have not been affected, but labourers and daily wagers are worried. People who work in shops are worried. Government employees are living in luxury, they are getting paid and as all the offices are closed, they are on holiday.

Q: What are the people who’ve lost their jobs doing now?

M: This has rarely happened in our area. Those who are unemployed now are sitting at home.

Q: What is your opinion of Baloch nationalists and the army in the area due to the nationalists?

M: The Pakistan army is present everywhere in Balochistan. Things were very bad a couple years ago, now thank God they are very good. As FC (Frontier Corps) or as something else, but the army is everywhere. The influence of the Baloch Nationalists has diminished. The situation is bad everywhere though, such events keep happening.

Q: Do you think the situation with the baloch nationalists is going to affect how the epidemic plays out?

M: No that won’t happen.

Q: In your opinion, how well is the Pakistani government handling the covid situation? What about the Balochistan government?

M: Both are not handling it well. Turbat is the second largest city in Balochistan yet there is no testing facility or other arrangements provided by the government. Leave aside ventilators, there aren’t even testing kits.

Q: How likely do you think it is you or your close relatives will get the coronavirus this year?

M: I think there is very little chance of that because this has not happened so far here so it isn’t likely.

Q: Do you have any other thoughts on this you’d like to share?

M: \[A prayer against the virus\]

Q: Thank you so much for taking the time to answer all of this :)

M: Thank you. We’re willing to help any time with any work or information you require.

Q: Thank you so much. Bye.

M: Bye.

M: Hi. I forgot to mention one thing yesterday. There is a high incidence of intermarriage here, which is why thalassemia is so common. It is also a cause of death in young children. There is no center or facility for thalassemia. These children need blood every fortnight or every month. Because there is no blood bank here, this is also the cause of their death.

Follow-up question later: Are people moving between cities and cities to the villages, and if so, is it minimal or more or less the same as always?

Answer: Yes, people are moving from one city to another but movement between cities is less than before. Movement between villages is same as before. The reduction in movement to cities is because of public transport being shut down.