For Muna Khan, a teacher at Karachi’s Institute of Business Administration, taking a six-day break to go to the mountains in Gilgit-Baltistan (GB) was a conscious but “difficult decision” as it meant she could be “exposing the locals to the coronavirus”.

This summer, nearly 200,000 people have made the journey to GB, with many others travelling to the province of Khyber Pakhtunkhwa (KP). The government officially reopened various sectors, including tourism, on August 8 after it was convinced cases of Covid-19 had gone down considerably. But the green signal for travel has spotlighted poor enforcement of Covid-19-related protocols and has dire implications for an already beleaguered healthcare system.

Reviving tourism

When the government announced the restart of tourism in a “controlled” manner, the idea was to begin with relatively low-contact, less-crowded businesses such as mountaineering, trekking, paragliding and rock climbing. The decision was primarily taken to revive the seasonal occupation of people directly and indirectly connected to the tourism industry — which employs just under one million people in KP.

Aftab Rana, the chairman of a “tourism recovery committee” formed by the National Tourism Coordination Board, said it was a step in the right direction since Pakistan had “flattened the curve” and reported a consistently low number of new cases. The official tally of daily new infections across the country fell from 842 on August 7 to 450 on August 24.

“The decision taken by the GB government to open itself up will prevent a large section of the population from falling into immense poverty because tourism is the only source of livelihood,” said Rana. “The people in rural parts of GB can do a little bit of subsistence farming and raise livestock, but that is not enough to meet the demands of the increasing population.”

Poor enforcement of rules

“This year, GB has seen the [influx of] more affluent tourists who would generally go abroad for the summer holidays,” Iqbal Hussain, the province’s tourism director, told The Third Pole.

Muna Khan said she travelled “responsibly” and adhered to the standard operating procedures (SOPs) developed by the government.

The regulations for tourists entering GB include carrying proof of a negative Covid-19 test result, a confirmed hotel booking and a travel itinerary to make contact-tracing easier. The rules say travellers should be screened and registered at all entry points and suspected patients should be immediately quarantined at their own expense.

For lodgings, only hotels with ample space have been given clearance to operate, leaving out small one- and two-bedroom guest houses. A maximum of two guests are allowed in a room, and both hotel staff and guests must wear masks at all times in public areas.

“We [Khan and her sister] were tested for Covid-19 before travelling, wore masks throughout, sanitised our hands often and disinfected any area we sat in before and after using it,” said Khan, adding that they visited places that were “off the beaten track, so as to avoid crowds”. She also quarantined for 14 days after her return to ensure she would not infect others if she was carrying the virus.

But many people are ignoring the government-mandated SOPs. During her trip, Khan said she saw tourists and locals in GB flouting the basic rules of distancing, mask-wearing and sanitising. And while hotel managers in all the four hotels she stayed in asked whether they had their Covid-19 test reports, not one asked them to share the test results with hotel staff.

A woman who travelled with her husband and three children from Lahore to GB said none of them had been tested. “I was not willing to pay PKR 6,000 [about USD 36] each for the test. We have a certificate from a doctor saying we are all well and not suffering from any coronavirus symptoms,” she told The Third Pole.

Naiknam Karim, who has been a tour operator for 25 years, said the fear of spreading Covid-19 kept him from starting his travel agency Adventure Tours Pakistan this year. “Tourists visiting GB may potentially be returning with the virus to their respective cities because locals are not following any SOPs and neither are they getting tested when they have symptoms,” he told The Third Pole.

Abdul Mubeen, the district health officer in Gilgit, said that locals were not observing distancing protocols under the belief that “Allah will protect them”.

Mubeen shared a development that illustrated how poorly SOPs are being enforced. “Two weeks back, 23 people staying at a five-star hotel in Gilgit were tested and two were positive. Six more tested positive in another city, Chilas. But by the time their reports came, none of them was in the city where they were tested. The two who were in the hotel in Gilgit were informed but the other six could not be traced and informed as they had either given us wrong phone numbers or were in areas where the phone signals were weak.”

Cases on the rise

Data shared by the National Command and Operation Centre (NCOC), which collates the number of Covid-19 cases and deaths in Pakistan, showed that the number of coronavirus-related deaths on July 30 in Gilgit-Baltistan was 3; on August 25 it was 65. Testing is still low, with no more than 300 tests done each day — all by government-run labs.

Hafeez ur Rehman, the former chief minister of GB who fought not to open the region to tourism, said he was not surprised that the SOPs have been “all but thrown out of the window by the deluge of tourists” entering GB.

On August 7 (before GB reopened to tourism) there were 2,301 infections, according to the NCOC. On August 25 there were 2,720 — an 18% increase in 18 days.

Last week, Shah Zaman, GB’s focal person for coronavirus, said that Covid-19 cases in the region may get “out of control” if SOPs are not enforced because the area has limited healthcare facilities. A news report in Dawn quoted him saying that “at least 150 cars carrying tourists” entered the region daily with “95% of the tourists” not carrying their Covid-19 test results.

The Third Pole previously reported on GB’s poor healthcare infrastructure. “The doctor to population ratio in G-B is alarmingly disproportionate i.e. 1:4100 whereas the national statistic is 1:1206,” said a study published in the Pakistan Journal of Public Health. “This statistical evidence testifies to the stark reality that healthcare in Gilgit-Baltistan is in an appalling state.”

Rana said the responsibility for ensuring strict compliance with SOPs lay with the district administration. “They have recently set up the tourist police [which has 37 patrol cars and 24 motorbikes], which should impose penalties for non-compliance,” he said.

Rana admitted that the screening carried out within the 10 districts of GB “was not enough” and remained limited to checking temperatures with thermal guns or noting down national identity card numbers.

“We can restart tourism safely by making visitors conscious of their responsibilities and by building the capacity of tourism service providers and hoteliers about strictly following the SOPs,” said Rana. “On top of this we need a strict regulatory mechanism in place with heavy fines for violating SOPs. That is the only solution.”

Header photo by Naveed Khan shows a traffic jam as people travel to the mountains in northern Pakistan.

This article was originally published by The Third Pole and has been reproduced with permission.