Passing through the fertile agricultural lands along the bank of the tamed Indus River on either side, be it the Indus Highway or National Highway, may often mesmerise the traveller. But the flanking dusty towns of rural Sindh have been woven into a rare enterprise where new rules of business rule the roost.

The old order is replaced by a neo-sociopolitical setup led by the local politician who partners with government servants and police officers, appointed on his will, his coterie (local collaborators) and the media. The whole set of development in the rural landscape is designed through a prism that focuses on a select group of people, pushing the poor deep into poverty.

"Sindh has spent over Rs2000 billion on development over the last decade," says Fazllulah Qureshi, former chief planner of Sindh. "But the Annual Development Programmes (ADPs) of this province are devoid of statistics which once were the hallmark of the Planning and Development (P&D) Department of Sindh. Now the ADPs are created by contracts and business groups owned by the kith and kin of local political leaders."

This huge development money has created a brand-new affluent class, a relatively new entrant in the political arena without a history of political struggle or any contact with the masses. At the same time, it has left widespread clusters of poverty in rural Sindh.

Larkana, the bastion of political power of ruling PPP, has witnessed a development buzz over last many years. There are a number of development schemes in almost all sectors but the contracts are sure to go to a select group. "We have a number of newly rich people who now control a big part of rural economy and they get each and every contract to launch a new business," says Khalid Chandio, a rights activist who has lived over a half century of his life in Larkana.

Larkana is not the only place where this is happening. Major district headquarters of northern Sindh -- be they Shikarpur, Jacobabad, Sukkur or Ghotki -- have a similar story. All these districts have thousands of infrastructure development schemes, schools buildings and health facilities and boast of numerous state-of-the-art buildings.

"But all this development earned the grand ruling coterie over half of the development outlay -- Rs1000 billion -- through a set of commissions and kickbacks over the last ten years," says Qureshi.

"The rate of commission on development schemes in Sindh varies from 40 to 50 per cent," he says. However, a group of contractors from Jacobabad claimed last year that it has reached 60 per cent, forcing them to travel to Karachi to stage a protest in front of the Karachi Press Club.

"Contractual business and subsequent commissions are not restricted to northern Sindh only. Central and lower districts are also awash with wealth," says Haroon Gopang, a local journalist based in Badin.

From Larkana’s brick manufacturers and solar panel traders down to urea and pesticide traders of Badin, all have one thing in common -- partnership with the ruling rural elite.

Many hospitals, rural health centres, educational institutions, major roads, farm to market network are a reality of today’s rural Sindh but seldom have any of these contributed to the improvement of development indicators. Millions of rural dwellers live with Hepatitis C, hundreds of children die of measles, infant mortality ratio refuses to improve, women health initiatives remain low, medicines don’t exist in the hospitals and doctors refuse to pay attention.

Sindh’s Health Minister Dr Azra Pechuho says "she is trying to locate a big number of ghost doctors who are on government payroll but do not show up". Almost all hospitals in rural Sindh are functioning with below the sanctioned staff strength.

Many major hospitals are being managed by the private sector under the Public-Private Partnership Programme. "But the counterpart funding from the provincial government is a big issue," says Adam Malik, one of the private managers at Thatta Hospital. "We are unable to pay salaries to the staff, as the government funds are drying up".

Badin and Larkana just replicate the Thatta model where expensive biomedical equipment could not be unpacked because there was no technician to operate it.

Education -- the most talked-about sectors of the province -- also stands unsuccessful in gaining the trust of the people. Even though Sindh’s Education Minister Syed Sardar Shah got his only daughter admitted in a public sector school in Hyderabad, no one from the landed aristocracy has emulated him so far.

The worsening governance at government hospitals and educational institutions has given away to huge dividends for the private sector in each city and town of rural Sindh. Thus, thousands of private schools and hospitals are the order of the day.

Another devastation has descended due to depleting irrigation supplies in Sindh’s irrigation system -- currently facing a 40 per cent shortage for Rabbi season -- and also higher agriculture input costs, making agriculture unfeasible. This coupled with low support price offered by the government has left thousands of small growers and peasants redundant, especially on the tails of canal system all along the Indus River.

If Larkana, Dadu, Sanghar and Shikarpur have exceeded beyond their town limits so are Badin and Thatta -- two coastal district headquarters of Sindh -- where not only neighbouring rural populations have flocked but huge migration from Indus Deltaic areas has taken place. It has put the existing system in huge stress and town management systems have virtually collapsed.

Frequent dry spells downstream of Kotri have allowed sea water intrusion eroding over 2 million acres of agricultural lands in coastal districts and it has also seeped into aquifers up to Mirpurkhas -- the home of the export quality mango of Sindh. "Our lands are badly affected because of the stoppage of fresh water to the sea because the underground water has become brackish swallowing per acre yield of the lands," says Dr Karim Khawaja, a former PPP Senator hailing from Tando Mohammad Khan, an adjoining district of Hyderabad.

The situation has given impetus to huge migrations in the length and breadth of rural Sindh leaving rural towns with only the poorest and the richest who control their political constituency. The middle classes have shifted to bigger cities like Karachi and Hyderabad which continue to attract them.

Meanwhile, in the big and small towns of rural Sindh, money earned through commissions revolves. The subsequent investments are reflected in the number of Sindhi students in expensive private educational institutions in urban centres of Sindh, Sindhi women buyers in shopping malls and a glittering lifestyle for newly rich rural population. While the poor have nothing but to live on earning of the pushcart in districts where the few known industrial zones, such as Sukkur and Larkana Industrial Area, have now become a story of the past.

Sindh has over 12 oil and gas rich districts where multinational exploration companies are busy drilling wells but all create very low employment opportunities for locals.

The claims for Thar’s development however are tall where Sindh Engro Coal Mining Company (SECMC) -- a joint venture of Sindh government and the Engro Powergen -- has almost drilled down to the coal seam.

Once a dream for many people of this province, the whole desert and its towns like Mithi and Islamkot which sits on billions of coal deposits are no different from the barrage districts of Sindh. The development paradigm is the same -- there are partnerships for earning through ‘commissions’, health and education sectors are in a shambles, highways and inter-subdistrict network seems healthy but the health of mothers who give birth to fragile children is at risk.

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"It’s not health facilities and governance only which create such a situation," claims Dr Suresh Kumar, a senior medical officer who has studied the frequent infants’ deaths in Thar. "Ancient traditions in scheduled casts stop womenfolk from having nutritious intake and this creates vulnerability among them."

"Leave aside the outdated tradition for Hindu low caste women; the healthcare and education initiatives by successive governments have not yielded results either," says Ismail Bajeer, a local journalist. "Doctors at government hospitals, even in Mithi where the whole media is focused, refuse to work."

Dry spells in the desert and subsequent un-employment have pushed a big chunk of the younger population to enter into the labour market in Hyderabad and Karachi. For many, SECMC’s Corporate Social Responsibility (CSR) and employment programmes are a distraction.