I have been reading about the harsh realities driving so many talented young Pakistanis to seek futures abroad, and I can assure you: the bitterness they feel is not new. It is the same toxic water that drove me, thirty-two years ago, to make the agonising decision to leave the country I had so eagerly chosen to serve. The specific details may change, but the system of sifarish, bureaucratic cruelty, and professional exclusion remains tragically constant.
I returned to Pakistan in 1985, armed with an education from abroad and a fervent desire to contribute to the nation’s health sector. My very first hurdle was an unpaid internship at Services Hospital, Lahore, a position secured only after navigating the torturous, humiliating path of sifarish and influence. The indignity of this was quickly compounded by the realisation that competence was secondary to sycophancy. To merely sustain my position, I was immediately required to ingratiate myself with my superiors, a practice that nauseated me.
The betrayal of merit continued even after a major achievement. I passed the arduous Public Service Examination, securing the 13th position out of approximately 1,100 candidates. My reward for this academic excellence was not recognition, but exile: I was posted to a remote part of southern Punjab and fed directly to the powerful wadera system. The conditions were hellish, a brutal negation of the service and opportunity I had envisioned.
After three years of relentless toil, I managed to secure a post at Mayo Hospital. But here, too, I was immediately deemed an outsider, not a KE graduate and the isolation was stark. I was the lone sheep among a pack of wolves. The next six years and nine months were a series of demoralising transfers within the health ministry, deliberately engineered to deny me stability and the focus needed to train in my chosen field, paediatric medicine. Suffering at the hands of indifferent civil servants and sycophantic senior professors, my hopes were shattered, and my dreams broken.
The youth leaving are not abandoning their homeland; they are fleeing a system that refuses to value their talent or honour their dedication
I began preparing for the United States Medical Licensing Examination (USMLE) instead of the local FCPS exams. I knew, with a certainty that chilled me, that even passing the national certification could not save me from the brutalities of the corrupt system.
Leaving Pakistan was not easy. I had a wife and three young sons, and my parents were reaching the age where they needed me most. My late father, a gentleman of few words who had himself returned to Pakistan after earning his doctorate in Agricultural Economics from WSU, observed my misery in silence. Then, on a hot and humid August evening in 1992, he offered me the words that became my life raft:
“Son! Standing water becomes stale and toxic, be the river that flows.”
Those words, born of his own wisdom and his silent understanding of my suffering, gave me the courage to make the biggest decision of my life.
The first few years in the United States were difficult for my family, yet the professional environment was a revelation. There was no sifarish; every step forward was earned purely on merit. I was encouraged, supported, and recognised for my abilities. As I now reflect on the canvas of my life, I count both what I achieved in professional fulfilment and what I lost: my parents, during those years, when I could not be with them as they needed me most. I am sure they are looking down upon my family now with continued prayers.
The escape continues today because the water remains stale. The youth leaving are not abandoning their homeland; they are fleeing a system that refuses to value their talent or honour their dedication. They are choosing to be the river before the standing water turns them toxic.