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The International Physicians for Prevention of Nuclear War organizes meetings between countries with nuclear capability. Khagendra Dahal was part of the delegation that visited India and Pakistan

This is Wagah, the recently reopened Indian-Pakistani border. After being closed for 18 months because of escalating tension between India and Pakistan, it reopened in July 2003.1 We can see hundreds of people walking through this border, which links Indian Punjab with Pakistani Punjab. A Pathan, one of the ethnic groups in Pakistan and Afghanistan, from Pakistan is hugging goodbye to a Punjabi from India--a touching scene. This recent opening of Wagah has given the opportunity to many people to reunite, especially long-separated relatives.

I was one of the international delegates that comprised of physicians and medical students from Nepal, India, Pakistan, Sri Lanka, Sweden, Malaysia, the United States, and Russia. The delegation was organised by International Physicians for the Prevention of Nuclear War, which won the Nobel peace prize in 1985. Established in 1980 by doctors from the United States and the former Soviet Union during the peak of the cold war, the organisation advocates for peace, people's health, and nuclear disarmament.2 My connection to the organisation was as national medical student representative of the Nepalese affiliate, Physicians for Social Responsibility. Four Nepalese--three doctors and myself--had joined the group.

International Physicians for the Prevention of Nuclear War sends delegation teams to all the nuclear capitals of the world. These teams talk with the decision makers--politicians, parliamentarians, diplomats, researchers, and economists--of the country.3 They discuss the medical consequences of nuclear war and proposals for disarmament.#

This time, the team was going to talk to the decision makers of India and Pakistan to put pressure on them to act judiciously on the issues of nuclear weapons, paving the way to nuclear disarmament of South Asia.

"South Asia is the most dangerous region in the world in terms of the nuclear arms race," says Ron McCoy, professor and president of International Physicians for the Prevention of Nuclear War. Historical rivals India and Pakistan have nuclear warheads pointed at each other making the region the potential epicentre of a nuclear war. India and Pakistan have fought three wars since Pakistan was separated from India in 1947. The beautiful hilly region of Kashmir has been the difficulty between them since the partition.4

South Asia is poverty stricken. A third of South Asian people (around 433 million) are living in abject poverty.5 Many people have no access to food, shelter, health, or education, and investment in nuclear programmes has made the situation worse.

"Coming together is a beginning, keeping together is progress, and working together success," was on the wall in the office of the federal minister of health of Pakistan. The health minister was well versed and supported what we were doing. We talked about the health impacts of exploding nuclear weapons and Pakistan's preparedness in case of accidental or intentional explosion.

Indian doctors should have joined the delegation to Pakistan but could not. They were denied visas and clearances, which are essential for a visit to Pakistan. When we reminded the health minister of this, he said, "Visas will not be a problem for such activities in the future."

Similarly we met the chairman of senate and the foreign secretary and talked to them about similar issues. They agreed to foster confidence building measures, including dialogue between the two countries at the level of people--doctors, artists, scientists, writers, journalists, and the general public.

One thing was clear from the meeting: Pakistani policymakers think they need a nuclear arsenal to secure themselves from India. They said that regional disarmament was unthinkable unless India disarms. Most people we met shared similar views.

Part of the trip included meeting the "missile man of India," President APJ Abdul Kalam. We started by saying that nuclear war would be the final epidemic since all the health and medical infrastructures would fail. But, he challenged us: "As physicians you should not say there is no treatment of nuclear explosion; we can do bone marrow transplantation."

The president's love for children and young people is often shown on television. I asked him how he reconciles his love of children and his vision for their future with his nuclear weapons programmes. He said only, "I love children because the future of India lies in them," avoiding the nuclear issue.

We also met the leaders of some political parties. Most emphasised the "deterrence theory." This argument says that to prevent a country from firing nuclear weapons against them, they keep a nuclear arsenal saying they will reciprocate. Nevertheless, most parties said that they were hopeful about bringing lasting peace to the region.

The people of India and Pakistan want the disputes between their countries to be settled peacefully: "We want no more wars but friendship," said one Pakistani when asked how he views the current relationship between India and Pakistan.

But when it comes to the nuclear issues, India seems more liberal. The Pakistani people I spoke to were reluctant to unequivocally support disarmament. Most of them said that they should own nuclear weapons so long as India does.

Doctors should talk about the health, medical, and environmental hazards of nuclear weapons and educate the medical community and policymakers about the consequences of nuclear war. The main argument is that nuclear bombs are not just bombs which are bigger in size and have a more devastating capacity than the others. Nuclear bombs do not discriminate between combatants and non-combatants; they destroy humanity.

International Physicians for the Prevention of Nuclear War has about 60 affiliates all over the world. Medical students can help to establish peace and disarmament by getting involved in their own country.6 Students also have a project called Nuclear Weapons Inheritance Project that visits nuclear states and engages in dialogue with medical and other university students about nuclear weapons. The main objective is to create a group of students who understand the consequences of the nuclear arms race. Resources are diverted into nuclear programmes that could provide food, education, shelter, and health to many people.

Courtesy: studentBMJ 2004;12:221-264 June ISSN 0966-6494
Khagendra Dahal fourth year medical student,

Institute of Medicine, Kathmandu, Nepal
Email: khagenvikram@hotmail.comIndia-Pakistan border opens cautiously. Taipei Times 2003 Jul 12:5.

www.taipeitimes.com/News/world/archives/2003/07/12/2003059055 (accessed 13 May 2004).

International Physicians for the Prevention of Nuclear War. IPPNW: a brief history. Cambridge, MA: IPPNW. www.ippnw.org/ IPPNWHistory.html (accessed 13 May 2004).

International Physicians for the Prevention of Nuclear War. Nuclear war prevention: dialogue with decision makers. Cambridge, MA: IPPNW. www.ippnw.org/NukeDialogues.html (accessed 13 May 2004).

Hamin A. Anatomy of Indo-Pak wars: a strategic and operational analysis. www. defencejournal.com/2001/august/anatomy.htm (accessed 17 May 2004).

Karki A. et al. Poverty in era of globalisation: poverty in south Asia 2003. Kathmandu: South Asian Alliance for Poverty Eradication, 2003:2