We are having the third consecutive administration of the Pakistan People’s Party in Sindh since 2008. The veteran politician Syed Qaim Ali Shah headed two administrations and was replaced by a comparatively young and foreign graduate SyedMurad Ali Shah. He was expected to perform better than his predecessor focusing on urban development, education and healthcare. He has already been at the helm of the provincial administration for over three years but there has not been any improvement in life in the urban centers of the province. The decline in the education, healthcare and sanitation in the cities and towns has continued unchallenged. It seems these social sectors, as usual, have the lowest priority with the new leader too. I had the opportunity to pass a week in the lower Sindh staying or visiting the main towns including Larkana, Qambar Ali Khan, Shahdadkot, and Jacobabad. I also made stopovers in Dadu and Sehwan. All these towns present a sorrowful picture of pathetic neglect of roads and streets, sanitation, garbage collection and healthcare. Roads and streets are broken; over-encroached; over-soaked with the sewerage water of the overflowing surface drains; over-crowded with motorcyclists, donkey carts and pushcarts and stray dogs, roaming freely and scavenging heaps of garbage in groups and baring their teeth to the pedestrians. Both the underground and surface water in all the towns is polluted and, therefore, injurious to human health. The water borne diseases like typhoid and dysentery are on the rise. The deadly hepatitis has become a common disease and devoured many members of certain families. The affluent families in Shahdadkot consume bottled water. The majority of the population lives on water fetched from the water hand pumps outside the town and sold by men in this old business. This petty business has been carried over from the early 1970s.The underground water of Shahdadkot, Qambar Ali Khan and Jacobabad, apart from being highly polluted, is brackish and cannot be utilized for cooking, drinking or shower. The level of the underground water in Larkana has sharply dropped as almost every house has a water hand pump along with a motor to suck out water. The water has been found injurious to human health. The health conscious residents have started boiling the water before consumption. However, over 90% of the bulging population of the city consume water without boiling it and suffer from stomach ailmentsand frequent bouts of typhoid. Our medical universities are producing doctors by hundreds every year. None of them is willing to serve outside urban centers because of the lacking facilities of clinics, residence, medicines, security of life etc The public hospitals are thronged by crowds of patients every day. It is a pathetic scene to see helpless patients and their attendants running helter and skelter in the pursuit of doctors and paramedics. The population of all these towns has almost quadrupled due to the high rate of population growth and rapid urbanization but there has not been any addition to the healthcare centers. For instance, the civil hospital Larkana, Shaikh Zayed Women Hospital, Shaikh Zayed Children Hospital and the Chandka Medical Complex were built by the first PPP regime under Z.A. Bhutto. No new hospital was ever built in the city during the past five decades. Some of these old health facilities are inpathetic condition of neglect and mismanagement. Shahdadkot also has the single civil hospital built in the mid 1970s. Now these health facilities cannot adequately meet the needs of the huge populations. Basic health units in villages are almost unknown in Sindh. This has provided a flourishing business to the quacks. They do not follow the established practice of using disposable syringes. This has given rise to hazardous diseases like HIV and Hepatitis. Over 1000 cases of HIV were reported in Tehsil Ratodero of Larkana with entire families infected with this deadly virus. No worthwhile action seems to have been taken for the treatment of the HIV patients or any crackdown launched against the quacks. Our medical universities are producing doctors by hundreds every year. None of them is willing to serve outside urban centers because of the lacking facilities of clinics, residence, medicines, security of life etc. Quite recently, the pathetic deaths of people including young children infected with rabies in Larkana and in the surrounding towns were shocking. They were turned off by hospitals on the plea that vaccines against rabies were out of stockwhile young children were gasping in the arms of their hapless mothers and dying a slow and excruciating death. The vaccines for dog and snake bites continue to be in short stock in the public hospitals in Sindh. Isn’t it shameful for so called people’s representatives. With the exception of a few neighborhoods, the entire cities of Karachi and Hyderabad are littered with garbage. Parts of these cities are completely under the sway of stray dogs attacking passers-by in gangs. The garbage collection, according to some insiders, has become a lucrative business to be contracted to favorite companies. Though the local body governments are in place, the mayors and chairmen of municipal committees, however, complain that their powers to manage the municipal affairs of their cities and towns are pruned. The local bodies are over staffed and the funds they receive every month are hardly sufficient to pay salaries and pensions of their employees. There are reportedly hundreds of ghost employees in every corporation, municipal and town committee. The education has gone from bad to worse over all these years. The public schools present a pathetic picture of neglect. There is a race among the supervising officers to amass wealth before their retirement. The Boards of Examination, offices of the District Education and Sub Divisional Officers have become dens of corruption, favoritism and cronyism. Cheating is galore in examination centers; the business of selling and buying grades leapfrogging without let and hindrance; funds for the maintenance or uplift of school buildings are swindled with impunity. It seems education has lost its importance for our ruling oligarchs whose children benefit from known schools and colleges in the country and fly abroad for higher education. To be concluded The writer was a member of the Foreign Service of Pakistan and he has authored two books