The state is constitutionally responsible towards its citizens without any distinction of caste, creed and class for their fundamental rights, including education and healthcare, security of life, property and honour, livelihood through its executive branches in both federal and provincial territories. In constitutional democracies, the elected political administrations undertake this responsibility for the state in an earnest way. The situation in our evolutionary democracy is distinctly different. The elected governments of the day have utterly failed to carry out in a gratifying way the state’s responsibility to provide its citizens with education and healthcare, security of life and property. Though the situation in all the federating units, more or less, is identical, Sindh has suffered more at the hands of its inept leaders. Nothing of its precious resources, including provincial exchequer, lands, Islands, financial revenues and oil and gas reserves, have been safe and secure. The credibility of the political administrations of Sindh to protect the provincial resources and properties for decades has been quite disappointing. They have rather earned notoriety for callous leakage, mismanagement and wastage of provincial resources. The plunder and mismanagement of provincial exchequer and properties during the past decade under the PPP administration has been unprecedented in the annals of the recent history of this land. The apartheid in education has been imposed by the upper class; leaving the lower middle and poor classes with their children languishing into the pathetically managed public sector schools. Though the standard of education in public schools, colleges and universities has been steadily declining for many decades, the current long spell of rule by the Pakistan People’s Party has turned the entire education system into a farce. There is chaos in the management of primary and secondary schools, recruitment and promotion of teachers, admission of students in medical and engineering universities – with rampant corruption and corrupt practices. The children from the affluent class seek admission in the expensive private Institutions. This apartheid in education has been imposed and perpetuated by the upper class leaving the lower middle and poor classes at the social fringe with their children languishing into the pathetically managed public sector schools manned by incompetent teachers. The qualifying marks of the recent tests for recruitment of new teachers were gradually reduced to 33%. This new lot of teachers would teach in public sector schools and prepare the children of the poor for the competitive job market. The healthcare system in the province presents a pathetic picture of this class distinction. There are private modern and expensive hospitals concentrated in the capital city for the elite class. These hospitals charge huge amounts for simple operations with a few days of hospitalization ranging between Rs.0.5 to 0.6million. All these hospitals have been constructed on the prime lands of the province. Many of them have transformed into equally expensive medical universities to amass more wealth. Every day, we come across many instances of their callousness. On December 22, Nazia Solangi, a bright young girl, injured in a road accident in Mithi, the capital town of Tharparkar, was rushed to Karachi. The privately managed Memon Hospital refused to attend the girl unless the relatives deposit in advance Rs.0.5million for her admission and treatment. The relatives could not arrange this big amount in time, and Nazia lost the fight for life at the door of this hospital. There was an uproar of protests in social media on this outrageous callousness of the hospital administration. The public hospitals catering for the poor are overcrowded, grossly mismanaged and bereft of basic facilities and services including lifesaving drugs. Their condition at the district and Tehsil level is more appalling. The absenteeism among medical officers and medical staff is rampant and the leakage of funds is endemic. People die on roadsides or on their way to the main cities and women deliver on footpaths with the shadow of death hovering over mothers and infants. Notwithstanding the overall dismal situation in the healthcare systems, many an initiative by a few iconic sons of Sindh from this noble profession, hold out hope for the hapless citizens of this land. Dr Adeeb Rizvi is the pioneer of this dedicated group of medical professionals. He has been running the Sindh Institute of Urology and Transplant (SIUT) Karachi for decades providing medical care to kidney patients free of cost. He has been trying to expand SIUT to other cities of the province. He has prepared his team of Urologists to run the Institute. Dr Rahim Bukhsh Bhatti, a noble son of Sindh established the Gambat Institute of Medical Sciences (GIMS) some years ago and kept running it on donations. Now it is also partially funded by the Government of Sindh. It is a state-of-art hospital fully manned and equipped for surgery, transplant and treatment of complicated afflictions. Gambat is a small town on the main highway between Sukkur and Hyderabad. Yet another iconic figure of the medical profession – Dr Saeed Quraishi, the current Vice-Chancellor of DOW Medical University – took a gigantic initiative to ameliorate the medical services at the old Civil Hospital Karachi. He planned and supervised the construction of the Benazir Bhutto Trauma Centre in the proximity of the Civil Hospital, funded by the Government of Sindh. The magnificent 15-storey building of the Trauma Centre with competent and well-behaved doctors and medical staff, clean and furnished wards and modern facilities for surgery and treatment is a distinct eye-catching and refreshing sight within the overcrowded premises of the Civil Hospital. Recently, a young boy from my family was admitted for neurosurgery in the Centre by Professor Imran. I have had firsthand experience of the courtesy and empathy of surgeons, doctors and medical staff at the Centre. Poverty is on the rise with the elite amassing more power, wealth and resources and the poor become poorer. The law and order situation is dismal. The roads and highways of the province are unsafe after sunset. Robberies and abductions are endemic. The forests in the riverine land of Sukkur, Shikarpur and Kashmore are ruled by dacoits. The policing system – corrupt to the core – has collapsed. Honour killing is rampant. The author was a member of the Foreign Service of Pakistan and he has authored two books.