Emigration or a Hegira (hijrat) is a hallowed Muslim tradition. After all, the Muslim calendar starts from the day that the Prophet (PBUH) and a small band of his followers emigrated under cover of darkness from Mecca to Medina. The reason they left was to escape ‘religious’ persecution. Present day Pakistan has many Muslim immigrants that came from India. Even many of the reasonably well to do Muslims from India elected to come to Pakistan, some for patriotic reasons and others who felt that they would rather be a big fish in a small pond than the other way around. From the early heady days of Pakistan, things have changed. Before I proceed further, I will in the interest of full disclosure state that I left Pakistan for the US in 1971. However, in my defence, I must tell the reason why I left when I did. That is indeed an interesting artefact in the history of Pakistan. I graduated from King Edward Medical College (KEMC) in 1970. In 1971 while I was doing my ‘house job’ in Mayo Hospital, Lahore without any intention to leave for the US, ‘the troubles’ in what was then East Pakistan got worse. The Pakistan army ‘grounded’ all the ‘Bengali’ officers and that included many if not most of the doctors in the Pakistan Army Medical Corps. Consequently, the army ran short of doctors and decided to conscript all male physicians that had just graduated. That of course included my class of graduates. Being faced by the possibility of conscription into the army or going abroad to the US, I chose the better alternative and left for the US. But then I did return thirty years later and have worked and lived here for the last eight years. During my recent visit to the US I had a chance to interact with many Pakistani expats, especially in the medical community. Most of them are not very happy with the way things are in the US but almost every one of them justifies their decision to stay on in the US based on their perception that things in Pakistan are much worse. Frankly, I am all for those who wish to emigrate to escape persecution or for the sake of financial security. As it is, the thriving ‘Anglo’ community in Lahore is gone — many of them that could have left for Canada or Australia a long time ago. The same is true of the Parsees in Karachi and sadly also of the Ahmadiyya community. Most of them left to escape overt religious persecution or else discrimination based on religious beliefs. Today we have visa regimes that prevent people from just getting up and leaving for another country in search of a better life. As such the true ‘economic migrants’ end up being smuggled abroad, often with disastrous results, but the wealthy and the well educated can get visas to live and work in the west, in Australia or in the Middle East. The question then is why do so many wealthy businessmen and successful professionals wish to leave and what relationship is there between this and the situation in Pakistan. Before I talk about these questions, it is worth it to point out that some of the family members of the president of Pakistan live permanently in the Emirates. Part of the family of Mian Nawaz Sharif has been living in London for quite some time and there was a recent brouhaha about the family of the leader of the opposition in the national assembly being US citizens. Also, the children of our latest ‘saviour’ Imran Khan live in the UK. And of course, the former president and prime minister of Pakistan before 2008 are both living abroad. Clearly none of them are victims of religious discrimination or economic deprivation. When the former leaders and families of our present ‘leaders’ opt to stay abroad, then that clearly is worrisome. What that suggests is that even our leaders are not too sure about the future of the country and worse, it would also seem that many in positions of power and authority use Pakistan as a means of creating personal wealth that they can then transfer abroad and then live on it. Obviously if the leaders think that, then others feel the same way. Therefore, it would seem that all those that are in a position to earn enough money in Pakistan and then go abroad plan to do so. Does this mean that our leaders and the ‘movers and shakers’ in our country do not care about the problems that face us? Not really, but I do think most of them lack the intellectual and physical courage needed to confront religious extremism and sectarian violence that are the major problems that confront Pakistan at this time. Sadly, there are not enough like the late Salmaan Taseer around. Fortunately for Pakistan, two important trends counter this ‘weakness’ demonstrated by our existing leaders. First is the rapidly increasing middle class that cannot all emigrate and therefore has the need to see Pakistan do better. Second, as democracy becomes established, the number of ‘stakeholders’ increases to that critical point where all of them cannot plan to leave when things fall apart. So there is hope that things might actually keep on getting better, not because of but in spite of those that ostensibly run this country today. And that brings me to my personal conundrum. The two major reasons that kept me in Pakistan over the last eight years are gone and so I have to decide whether I must return to the USA. Something however keeps me tied down to Lahore and that can best be described in a verse by Hakim Momin Khan Momin: Momin khuda kai wastay aisa makaan na chor/ Dozakh mein daal khud ko, kooai butaan na chor (Momin for God’s sake do not leave this place/ to hell with heaven, leave not the house of your beloved). The writer has practised and taught medicine in the US. He can be reached at smhmbbs@yahoo.com