Pakistan is neither the worst-affected nor the worst-performing coronavirus case in the neighborhood. In fact, the country experienced a sharp decline in infection and fatality rates after an early surge. Many bright spots of good crisis leadership have emerged in a number of cities and provinces. But in early March, a remote border crossing called Taftaan on the Pakistan-Iran border became a flashpoint. The experience delivered some important lessons on preexisting fragility, as cracks emerged between the national and provincial governments, between the provincial center and the deprived peripheries, and between citizens and the state. Based on accounts of first-hand experiences, and using Pakistan as a case study, this essay examines how Covid-19 exacerbated fragility where grievance and inequality were already rife.

When the WHO declared Covid-19 a global pandemic on March 11, the provenance of Pakistan’s pandemic experience had already been established by nationals streaming home from Iran, where there was a severe outbreak of the disease. On February 26, a Karachi student returning from pilgrimage in Iran became Pakistan’s first documented case of Covid-19. Pakistan closed the border in late February, seeking to delay the arrival of approximately 6,000 Pakistani pilgrims at the Taftaan crossing, 630km from the nearest major city, in the province of Balochistan. The Zaireen, predominantly Shias from communities across Pakistan, were returning home from holy sites in the Iranian cities of Qom and Mashhad, which were already heavily afflicted by the coronavirus. Facing an urgent situation, the government launched plans to quarantine the Zaireen in the stark, primitive landscape of Taftaan.

The Center and the Province

The federal government made major pandemic decisions through an emergency commission that became the National Command and Operation Center. Compared to other provinces, Balochistan is historically neglected and under-resourced, and it is also perhaps more dependent on direct guidance from the center. According to Pakistan’s constitution, “health” as an area of governance is the domain of the province, but an infrastructure exists for cooperation and coordination between the center and the provinces, and to deal with Covid-19 all hands were needed on deck.

By February 27, the special assistant to the prime minister for health had made a well-documented trip to Taftaan to arrange the pandemic response. There was concern that the burden had fallen to the most impoverished and ill-equipped province, and that additional resources would be needed. The minister designated Pakistan House, the main federal government building at Taftaan, as a quarantine facility, and pledged that a special team from the National Disaster Management Authority would aid the effort, but people we interviewed told us that supplies were dispatched late or were never manufactured in sufficient quantities. Hobbled by its preexisting deprivation, the border remained a poorly defended front line of the crisis.

In the first few days of March, as returnees poured in across the border, they were shocked and dismayed by the conditions of their confinement: the absence of medical personnel, the lack of sanitation or clear guidelines, and the unregulated movement of people inside the camp. “Inside the compound there were no standard operating procedures and no communications from the government,” said one witness. Provincial officials used thermometer guns to check temperatures once a day, but there were few standard measures for pandemic containment, like testing, isolation, or social distancing.

Alarm grew among the residents of the camp, many of whom had fallen ill. “I didn’t see any doctors,” said one of the quarantined, a tour guide. “The compound had Panadol and a few other tablets, but not even enough masks. Later, a container with a few medical supplies, manned by a pharmacist, was installed, but it was outside the compound.” As the days went by, the camp began to resemble, to this researcher, a holding area for displaced persons more than a quarantine facility.

We often see a national-security reflex as states rely on “muscle memory” to confront a crisis, simply replicating conditioned behaviors instead of adapting to new circumstances. Pakistan’s institutions have extensive experience managing refugees and displaced populations, but none managing contagion. At Taftaan, the Zaireen were subjected to a policy of vector containment without treatment or basic health, safety, or sanitation facilities. This response unfortunately created a petri dish for virus contamination, which then spread through the country.

The Province and the Periphery

Peripheral populations in Pakistan, particularly those in challenging topographies, struggle to obtain proper health services. Chaghi, where Taftaan is situated, is the largest district in the province, but it performs poorly on human-development indicators. As a border district, Chaghi hosts a scattered, rural population, including many Afghan refugees. With few functioning mechanisms for relief or containment, Chaghi was the least likely candidate for frontline crisis response. “I spent 22 days in the camp,” a resident told us. “For 18 days there was no testing. On the 19th day they did a swab test, and I tested positive.”

There were difficulties in finding and dispatching medical personnel. Staffing state health facilities in Pakistan’s peripheries is a challenge in the best of times, but in this case the prospective staff did not have confidence in their employers’ care for their safety. “There was too much fear about the pandemic,” said one, “and we knew there was no protective gear available.” The Young Doctors Association of Balochistan resisted deployment to Taftaan, and protests demanding protective equipment resulted in unsavory images of doctors facing a baton charge and being arrested for insubordination and agitation. The Lady Medical Officers also refused a Health Department order to go to Taftaan, and were then directed to file a formal explanation.

Citizens and the State

To add to a complicated scenario, Covid-19 inflamed an old sectarian faultline. Evidence from 2016 to 2019 suggests that trouble for Shia pilgrims at the Pakistan border has been a regular feature of their annual pilgrimages to Iran. The history of terrorist incidents in Balochistan requires security screenings that the border checkpoint is ill-equipped to process at speed. Border economies and trading systems are rudimentary on the Pakistan side, and the rough experience of traversing this terrain can sap a traveler’s confidence in the state.

For the minority Shia pilgrims who must navigate this passage, the difficult experiences at the Taftaan Gate have given rise to a somewhat “othered” sentiment. Returning pilgrims complain of being detained for long periods, which sometimes sparks protests, often in a sectarian vernacular. “I once spent three days in the crowd at Taftaan trying to get into Iran,” said a journalist who travels frequently in the border region. “There was a scuffle with the Frontier Constabulary—they used batons, and I even fell in the melee.” These narratives of alienated citizenship indicate a fragile social contract frayed by rankling grievance.

With this baggage, the Taftaan camp crisis also acquired sectarian trappings, as the media began to report that the Zaireen were “responsible for the spread of coronavirus in Pakistan.” When the angry and exhausted pilgrims were finally released from Taftaan, their onward journeys were beset by conflict and incident that led to openly sectarian blame and antagonism on social media. Independent media sources and government officials responded with warnings against a “Shia media trial.” Fortunately, the social media campaigns were effectively countered and did not progress to vigilante attacks, but the brief flare-up is a warning as we continue to see more virulent manifestations of Covid-fueled identity conflict in South Asia.

Conclusion

The coronavirus struck Pakistan at its most vulnerable points, clothing old problems in the new garments of the pandemic. On the one hand, longstanding structural inequalities and resource constraints hampered cooperation between the national government and the provinces. On the other hand, the government’s ineffective quarantine of the travelers reawakened old sectarian identities and resentments. Most important, though, is the outcome: in the underserved periphery of the borderland, the status quo remained unchanged in the hour of greatest need.

Ultimately, Pakistan’s Covid-19 story is one of good intentions, sincere efforts, and some success, but also one where cracks in an already fragile system derailed the best-laid plans. Covid-19 has shown that structural inequality is a problem in any context—one that defines who are the most vulnerable, where are the cracks, and where the crisis will seep through.