South Asians have a long and honorable history of migration. They took to the high seas for adventure or to escape political persecution for daring to challenge foreign rule. A substantial number left their homes to seek a better future, as the countries of their birth had suffered from plunder at the hands of colonists. Colonial rulers transported a great number as indentured laborers to Africa and South America. We can find their descendants in practically all countries of the world – in Sri Lanka, South America, Africa, West Indies and the venerable Indian colonies in California and British Columbia, Indonesian immigrants in Holland and Vietnamese in France. In the second half of the twentieth century a lot of Asians went west for higher education and unlike their pre- and immediate post-independence predecessors, many elected to stay abroad.
Europeans on the other hand were driven out by religious persecution and mass starvation. Adventurers were lured by the fabled riches of India and the spices needed for “preserving” food from going bad. I suppose you could call them state sponsored pirates. In their ignorance they called every land and people they came across after the country (East Indies, Indo China, West Indies, and American Indians).
Subject people tend to look up to the rulers and try to ape their norms, mores and traditions, but usually succeed in only becoming a caricature. It is a part of the psychological depredation of captive nations. Their own institutions are destroyed in the process. But one consolation prize of this cultural hegemony was that young people went abroad for higher education. This is not to say that their own countries would not have attained the level of technical and scientific knowledge if they had not been overrun. Japan, never directly ruled, developed faster than the western countries did, and managed to overtake them in industrial production, scientific discoveries and financial acumen in a matter of three decades, even after the devastation of WWII. China has similarly taken giant strides.
Most of the seekers of knowledge returned home, sometimes bringing white wives of generally, though not always, of lower social order in their own country. But these were the children of the native elite or the rare one possessed of high intelligence from genteel and impoverished stock, which would be sponsored for higher education with a view to marrying a daughter of the house. These Students concentrated on law, medicine or literature. The former made up the core of the leadership of Indian Independence movement. Jinnah, Gandhi, Nehru, Liaquat and most of their associates were London trained Barristers. Professors in Medical schools till nineteen sixties were exclusively UK trained. US and locally trained physicians joined the ranks later.
My professor of Surgery, Lt. Col. Said Ahmad, a man of high wit, intellect and learning, told us this story when we asked him about life in British Isles. He had gone to England in 1929, and stayed with a family for a while as a paying guest. He had heard that English girls were very friendly and provided “emotional support” to forlorn Indians. In his first evening in London, he went out, and roamed around the cold, wet and dreary streets, only to return after a few hours, shivering and crestfallen, that no damsel had accosted him, much less waylaid him.
In those days, British Hospitals did not pay any salary to trainees. They only provided lodging of sorts. Neighborhood bakeries and breweries donated bread, butter, cheese and beer to keep body and soul together. In return post graduate degrees did not necessarily ensure a good job on the staff of a medical school or as a civil surgeon. (1)
WWII brought an earth change. Flower of British manhood perished. There ensued an acute shortage of skilled and unskilled manpower. In the 1945 elections the labor party won. They introduced the National Health Service. British doctors boycotted it for a few years. To cope with the short fall the government actively encouraged doctors from the Indian sub-continent to come to the UK and a large number of the latter came to occupy the lower cadres of the service. A senior labor cabinet minister told me that the Service would not have survived without Indian/ Pakistani doctors. (2)
British government also offered all kinds of inducements and facilities for illiterate laborers to immigrate and work in the country. It was most certainly not an altruistic move. Working class was not only in short supply, but was in ferment too. Progressive movement was on the upswing in all of Europe. They demanded a living wage, fewer hours, job security, disability and sickness benefits, compensation for “on the job” injury, adequate pensions and decent housing. Manual workers from the subcontinent did not ask for anything. They flocked from Kashmir, Punjab and Sylhet and not only filled up the slots that could not be utilized for want of manpower, but also the ones that striking native workers had left vacant. The welcome they received from the establishment affirmed the analysis of Marx that capitalists will use ethnic, racial and other divides to sow dissension in the ranks of the working class. Seeds of hatred sowed at the time between whites, blacks, browns and yellows persisted and grew like weeds into a storm of racial riots.
In the early years of post independence, there were plenty of jobs at home left by the British and in the case of Pakistan, by fleeing non-Muslims. Later on, with no further expansion of health and other services in India and Pakistan, many had to stay put, working in junior ranks with nary a hope of a consultant (3) or similar senior appointment. Few foreigners attained the rank. Many joined General practice, earning as much money as consultants did. In law the former were actually a bit more important, and were put on a pedestal by their patients. Their only regret was that they had wasted so much time in Hospital service chasing postgraduate degrees and training. (At the time you only needed six months each in medicine and surgery to obtain a slot in General practice). Scientists, lawyers, accountants.
I arrived in NY in 1974; Canal Street in Manhattan had only Jewish discount houses. They were short with customers and in their stilted English would tell non-whites, “You want to buy, buy, or go away”. The whole Canal street market used to close down for Jewish Sabbath on Saturdays. When I left Brooklyn NY in 1980, one could buy mango ice cream on Saturdays and the natives spoke courteously with Brownies. The community came to own large swathes of high priced real estate in metropolitan NY, Chicago, Detroit and NJ, Florida and California and in most of the other states as well.
Many Physicians like me moved from England to Canada and USA and had to go through several years of training over again. I escaped the ordeal, thanks to the recommendation of a British consultant (As mentioned elsewhere he was the one who used to ask me to do all his work. He was better at politics than he was in orthopedics and was very well known in the USA) and landed a staff job right away. US Hospitals made one work very hard, and if you chose a surgical internship, it was literally day and night. But they paid about three times as much as one got in England and it was a two to four year well balanced training program, (The British got their act together only in 1995. Prior to that it was hit or miss, mostly a miss in sub specialty training. I have discussed it in chapters on the UK).
By the time I arrived in the USA in 1974, a substantial number of expatriate Doctors were well settled in private practice and lucrative and academic hospital based jobs, owned homes and had started investing in commercial property. They were well on the way to becoming substantial citizens. Like all upwardly mobile groups their next focus was on professional organizations. APPNA (Association of Pakistani Physicians of North America) was founded in the mid seventies, AAPI (American Association of Physicians of Indian Origin) a few years earlier. Both bodies developed into formidable lobbies exercising great influence on their communities and governments back home. It is especially true of APPNA on Pakistani rulers and a few of its leaders have parlayed their influence into cabinet level jobs back “home”. They enjoy easy access to congressmen and senators, and actively participate in the electoral process. Saudis, in conflict with Nasser, had expelled Egyptian caregivers. Government of Pakistan, always in financial bind to the West, and being hard put to “service” (payment of interest is euphemistically called service) the debt encouraged the export of skilled personnel. Bhutto who had been able to impart a bit of his self-respect and sense of solidarity to other heads of Muslim states, successfully induced them to hire Pakistanis instead of non-Muslims. This self-respect did not last very long.
Early sixties saw the trend change to Doctors passing ECFMG (6) examination and going to USA and Canada .USA, unlike the UK and Canada where you just had to buy a ticket (UK put restriction on immigration in June 1962 and Canada in December 1973), screened visa applicants, so only the educated or the rich investors could get in. This measure was good national policy, for every Doctor, Scientist and Engineer the country saved $200,000.00, it would have had to spend educating and training one of its own. And they did not even have to acknowledge the receipt of this aid!
Other educated persons and skilled workers also made a conscious decision to make their way to the USA. Engineers didn’t do particularly well till the influx of computer techs in the waning years of the twentieth century. Accountants, Attorneys, Dentists and pharmacists had more bothersome restraints put on them.
United States Government (USG) policy, as usual, was market driven. Investors, mostly Gujratis, made a beeline for the land of promise. They are a linguistic cultural group with unmatched ingenuity, initiative, financial skills, ingrained frugality and nerve. At one time you only needed $5,000.00 to get an investor visa. These gentlemen recycled the money bringing dozens of men, their spouses and children for the initial amount. USG, belatedly wise to the subterfuge, kept on raising the figure till it was a million, without making a dent on the influx .The community bought motels, small stores, news stands and gas stations. Now these amiable, low profile but shrewd people (both Jinnah and Gandhi were Gujratis – Gujjus – a campus sobriquet) own more than half of the country’s small and mid sized motels. They have literally driven Jews out of the discount business.
I remember when academics languished in junior level jobs and gradually drifted to the Mideast, Africa and Far East where they were treated as skilled slaves. Saudis routinely called Pakistanis “miskeen” – pauper. Lucky ones found jobs in the USA. Unskilled laborers worked in factories and municipal services (sanitary) or as waiters in Indian restaurants. They lived in ghettos, and often resorted to an ingenious arrangement – twelve to a room, in four bunk beds, in eight hourly shifts.
They cooked highly spiced and pungent curry. The smell drove white neighbors away, and caused real estate values to plummet. Later this technique of getting whole blocks of flats vacated was successfully used many times, till the British landlords got wise to the scheme and refused to rent the flats to South-Asians, however well dressed. That led to many race discrimination suits.
They saved every penny they could, built mansions in Mirpur (Pakistani Kashmir) where white shalwar/kameez clad women carrying earthen water pots on their heads was to become a common sight. The British laborer couldn’t go on strike, as there were plenty of brown workers to replace him. There was a backlash; gangs of hooligans with shaved heads (5) would beat up South-Asians who came to be collectively called Pakis. Manual unskilled workers had to stay put in the UK. A large number could not assimilate. Cultural, linguistic, racial and religious differences were too wide to be bridged. Their descendents usually got educated, spoke in the native accent, but faced racial discrimination in jobs, housing and in public services. Britain was in an economic slump. Bad times bring out the worst in people. In later years a large number of British born Asians were to be further alienated and reverted to fundamentalism. This was especially true of Muslims. But that is another discussion.
Awash in oil money, Saudi Arabia, Gulf States, Libya and Nigeria decided to expand their health services. Literacy rate in the countries was even lower than that in IndoPak subcontinent. They imported doctors, nurses and other health care professionals. Pakistan had an in-built advantage as the people shared the same faith with those of host countries. The largest export of healthcare professionals was to Saudi Arabia.
Their kids have gone into professions their immigrant parents found difficult to break into, like Law, Finance and Communications. The trait of self-reliance, courage and independence of young girls is particularly gratifying. They assert themselves; take no such nonsense that they are delicate, dainty, helpless and emotionally labile beings, who should have half as much inheritance as their brothers, and half the vote as a witness. We have come a long way from the portrait of “innocents abroad” of five decades ago and have come of age as a community, matured and stabilized into an integrated whole which owes allegiance to the land it lives and works in, and to which its future is inextricably attached, yet find time, resources and will to try to bring much needed solace to our kith and kin left behind at “home’ as most of first generation expatriates call the countries of their origin. They were strong enough to withstand, shaken, but not broken in spirit by the aftermath of 9/11.
As a part of the global trend there has been considerable regression to obscurantism. Christians, Hindus, Muslims and Jews, all are affected. In the fifties and sixties liberalism and secularism dominated. As a reaction to neo-imperialist hegemony and inept non representative governments in Asia and Africa which are unable and unwilling to tackle economic, health and educational issues and have failed to eradicate social crimes and control population explosion, a lot of people have sought shelter in orthodoxy, exclusivity and intolerance. With empowerment of masses, freedom of expression, diversion of resources from the bottomless pit of war machines to economic development, this reactionary phase will pass too, but not without a fight, in the process, fundraising and even running for office. In due course they become members of the establishment, belong to Rotary and other civic clubs and send their children to expensive private schools. The groups do a lot of charitable and social work. I would like to make a special mention of Asian American Network against abuse (ANAA) which is one of the more vibrant human rights Advocacy groups and lobbies for legislation to eradicate gender discrimination, honor killing and dowry murders.(7) It has spearheaded a successful campaign to high light violations of HR and gender discrimination in Pakistan.
Foreigners, especially Muslims suffered a tremendous setback and lost a lot of ground post 9/11. But they have exhibited a great deal of resilience and are inching their way back into mainstream society.
This brings me to ABCD’S (American Born Confused Desis, another campus nickname). South-Asian parents are highly focused (my American friends say obsessed) on educating their children. They forego vacations; some work two full time jobs to send the young ones to the most expensive schools they can get into. They make the children attend prep schools during vacations, (while their native peers are working summer jobs and partying) and get them tutored by private academies for SAT. (8) I personally know of instances when mothers have grounded kids for days if the school grades were not high. Their only competitors are Jewish mothers. Results justify all the parental dedication and heartburn.
These new Americans are upright citizens, and combine the virtues of both the worlds. They are bold, confident and honest citizens. They stand up for their rights, are not easily cowed by state apparatus, challenge any slight or discrimination, yet remain loyal to family, faithful to friends, and considerate of the dispossessed. They are articulate and social, and mix easily with “old” and “New” Americans alike. They have done well in their careers, reaching executive
1. In British India there used to be four luminaries in a district – Deputy Commissioner, Sessions Judge, Civil Surgeon and Superintendent of Police. The ranks were overwhelmingly drawn from white Britons. Many doctors joined the army or worked in junior civilian positions.
2. I was an assistant GP with surgery next door to his constituency office. I had sought an appointment with him on the insistence of one of my patients who had thirteen children with a fourteenth on the way, living in a two-bedroom apartment. She wanted me to request her member of the parliament to get her a house. I had gone to his office ready to be snubbed; instead I got an early appointment, received courteously by the minister who put me at ease by joking that I should have gone to the offices of the “Guinness Book of records” and assured me of his best attention to the matter. Ministers were admirably available to their constituents, but favored physicians even more. My patient, to my utter surprise but not hers, got a six-bedroom house. She brought a Magnum of high quality champagne for me.
3. Consultant, top of the heap in the medical profession, was the king of the roost with his own ward, medical and nursing staff, clinics etc.
4. The British till 9/11 followed the law of the land scrupulously. The government routinely lost cases on grounds of racial, ethnic and religious discrimination. In a famous case, courts ordered the government to bring back an Afghan family they had exiled to Germany on technical grounds. The minister had charted a plane to send the family away and had to charter another to bring them back. He lost his job and prospects of promotion. Things got worse after their own version of 9/11 known as 7/7.
5. They were called skin-heads. They prided themselves on this “paki bashing” Indians resented this sobriquet. They should not have. The British criminals were only affirming what Gandhi, Nehru and Jinnah had firmly believed in – the last till the intransigence of the former forced him to change his stance. This race based gangsterism traveled to Canada and the USA. The gangs, perhaps to compensate the much maligned Pakistanis called their outrage dot busting, referring to the red dot Hindu women sport on their foreheads.
6. The Educational Council for Foreign Medical Graduates was set up to evaluate the training of non-American Medical graduates. It set up an examination which all foreign doctors, except for Canadians, had to pass in order to apply for and be accepted for training in the USA. After a year of training you were required to pass FLEX – Federal Licensing Examination – also conducted by ECFMG that gave you a license to practice independently. The system was later changed. All medical graduates, Americans and foreign, had to take the same USMLE – United States Medical Licensing Examination.
7. It is a euphemism for tribe/clan murder rooted in the feudal mind set and is a thinly disguised subterfuge for keeping land and other assets in the family. The case of a girl (and her friend) accused of illicit sexual relations is brought before a tribal court. She is not allowed (if not already killed) to appear in her own defense, nor may she present witnesses. A guilty verdict is inevitably handed down. The pair is executed by the girl’s family. If the case ever gets into a formal court of law, perpetrators are granted lenient punishment on the grounds that it was a crime of passion. The practice in various guises is very common in Pakistan and other Muslim countries and to a lesser degree in India and Latin America.
8. The Scholastic Achievement Test is conducted by an independent commercial group and is given considerable weight during the assessment process for college admissions. Sixteen hundred is the maximum number of marks one can get in examinations. It is called the perfect score. In my hinterland of Bath NY several students, all of expatriate origin, made the grade.

I was born in Dewa Sharif, UP, India in 1939.
I went to school from the fourth to eighth class in Gonda, UP and the 9th grade in Jhansi, UP, India.
We moved to Quetta, Pakistan and went to school for the 10th grade and intermediate college in the same town.
I was in Karachi University 1954-57, then Dow Medical College 1957-62. I Was in the National Students Federation from 1954 to 1962, trained in surgery in the Civil Hospital Karachi 1962-65, proceeded to England 1965 and trained in General surgery and orthopedic surgery till 73, when I left for Canada 1973-74, USA 1974-83, back to Karachi 1983 and built a hospital and went back to the USA in 1991, been in the USA since.
I retired from surgery in 2005.
I have worked in various HR and Socialist groups in the USA.
I have Published two books ,:”A Medical Doctor Examines Life on Three Continents,” and ,”God, Government and Globalization”, and am working on the third one, “An Analysis of the Sources and Derivation of Religions”.



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