THE world looks a very different place from the confines of a Cardiac Care Unit: you tend to view events from a global perspective as intimations of mortality erode your ego and personal sense of invulnerability.

The excellent care meted out by the doctors and staff at the Aga Khan University Hospital includes an unofficial ban on the supply of newspapers. But for a news junkie like me, this sets off withdrawal symptoms, so I got my morning fix through papers from home. The recent sectarian butchery in three of Pakistan's four provinces confirmed what a number of us have been saying for years: you cannot export fundamentalist terrorism to neighbours without expecting a fallout right here in Pakistan. This rapidly rising tide of religious intolerance and violence is a harbinger of things to come.

But looking beyond our frontiers, we find that more and more, Pakistan and most Muslim countries are marching to the beat of a different drummer. While the rest of the world is largely caught up with material concerns, a growing number of Muslims around the globe are permanently preoccupied with the length of male facial hair, the degree of purdah women must wear, and what is and is not acceptable in their particular version of Islam. In this sad and sterile effort to define behavioural norms for the rest of us, these misguided but often violent individuals and groups have no idea of the kind of damage they are inflicting on the countries they live in, as well as distorting the image of Islam in the eyes of the rest of the world.

I know I have been addressing these issues fairly regularly in recent columns, but I am more and more convinced that the friction these elements will cause in international relations will shape events well into the next century. Samuel Huntington's controversial "Clash of Civilizations" aggregated the various power groupings and discussed the possibilities of conflict between them. According to Huntington, the Islamic bloc would be a major threat to the West, given the long history of confrontation between them.

Much of this thesis has been criticized and debunked. Indeed, the motley collection of Muslim countries scarcely present a threat to anybody but themselves. However, it is the armed and dangerous militant groups that have mushroomed around the world that threaten not just the stability of their host countries, but of the regions around them. The close links between these groups and the financing they manage to tap into have raised their profile and present them as a bigger danger than they now are.

But as the on-going killings in Pakistan demonstrate, these people are utterly ruthless in carrying out their agenda. Their anti-western activities may not amount to more than a few pinpricks, but they are nevertheless seen as a real threat. For a whole generation of these jehadis, the Afghan war against the Soviets was not only a proving ground, but it also forged links and alliances that are still intact 15 years after the invaders were driven out of Kabul. These fighters are now training another generation from Afghanistan to Kashmir to Chechnya.

In a sense, these zealots are nihilists, destroying what they see, insisting that they have to build their version of an Islamic utopia on the rubble of the erring societies they inhabit. With no stake in the system, they are aspiring to become ruthless killing machines that will sweep aside the corrupt, westernised elements that they see ruling much of the Muslim world. And if they fall, they will find their reward in the next world.

It is obvious that it is impossible to engage these people in any kind of meaningful dialogue. Convinced of the righteousness of their path, they will brook no argument and accept no legal limits to their actions. For them, democracy is only a system to be manipulated to achieve power as they certainly do not accept the prerequisites of democracy like tolerance and fair play. Although only a handful in most Muslim countries, these extremists have an influence on shaping the national agenda that is out of all proportion to their numbers.

Countries like Egypt, Syria and Iraq saw the threat posed by groups like the Islamic Brotherhood long ago, and cracked down on them viciously even when they did not pose much of a threat. But in Pakistan, a confused polity based on a yearning for democracy encouraged any and every charlatan with a vision to sell to set up a political party. Sooner or later, he received covert funding from one of our intelligence agencies or a foreign power. The Afghan war was a windfall as he not only got arms, but also acquired the stamp of respectability. As a bonus, many of his followers received advanced training in guerilla warfare, courtesy the CIA and the ISI.

Understandably, these politicians and their followers now do not want to go into a quiet retirement. On the contrary, the younger elements are more radicalized than their elders, and less ready to compromise. It is these holy warriors who are ready to take on the world on battlefields ranging from cyberspace to Daghestan. While disagreeing with their aims and methods, it would be a mistake to underestimate their motivation and their resources. Many of them are highly educated and have no problem with using modern techniques and tools to further their ends.

It is this breed of the modern Muslim fanatics that is seen as a danger both in the world he comes from and in the West. Indeed, the campuses of America have become hotbeds of revolutionary Muslim fervour. The Internet has given these elements a method of instant communication that is difficult to monitor, and zealous businessmen are glad to contribute to the cause. Arms, in this region at least, are no problem. The religious schools or madressas these organizations run provide a steady supply of volunteers. We have here all the makings of a frighteningly effective and organized armed force.

Unfortunately, no past or present Pakistani government has shown the least interest in taking on these militias. As the worst of them are currently targeting Shias whom they view as non-Muslims, the government probably feels it has some breathing space. But the truth is that despite the Punjab chief minister's recent charge that the Taliban were behind the current spate of killings (and since confirmed by the prime minister), this government can ill-afford to take on these fanatics.

The view from the West is one of increasingly violent Islamic countries. While more sophisticated westerners might make a distinction between mainstream Muslims and the fanatic fringe, most people will tend to lump us all together because that is human nature. How we interact with the rest of the world under these trying conditions will be determined by a number of factors. As for myself, I am reminded of Sinbad and the Old Man who gripped the sailor around the neck with his legs and would not let go.