Every few years there is some discussion about ‘dual nationals’ working in Pakistan. In such discussions these ‘expat’ types that return to Pakistan to work are viewed with some sort of suspicion, if not outright hostility. Here I will come clean and say that I am a dual citizen.

Concerning Pakistanis that have migrated to other countries, it is worth pointing out that migration (hijrat) has a very honourable precedent in Islamic history. Interestingly, when India became a part of the British Empire after 1857, the question arose whether India was no longer Darul Islam (House of Islam) and should devout Muslims continue to live in India. Fortunately, many senior Muslim clerics ordained that as long as the Brits allowed Muslims to practice their faith without restrictions, living in India under the Raj was just fine.

In that tradition, many devout Muslims now find it quite acceptable to live in secular western democracies where they are allowed freedom of religion. But it is not these people that are coming back to Pakistan as dual citizens today.

The economic refugees rarely return, religious refugees are also keeping a safe distance from Pakistan. The ones that we can expect to become dual citizens are the people of my generation and the ones that came after us for a couple of decades.

Many young people from the 1960s onwards went abroad for ‘higher’ education. Getting advanced medical training in the United States (US) for instance usually took five or six years - even more in my specialty of cardiac surgery. So, many like me got married during this time often returning to Pakistan for that purpose. And then we even had children! All that is probably true for many other types of advanced education.

The children born in the US were US citizens by birthright. After finishing our medical training many of us decided to get some experience and for that we needed a ‘green card’. Applying for a green card meant that you had declared an intention to become a US citizen. So you had to live in the US for most of the time if you wanted to maintain your ‘permanent resident’ status.

I don’t know about other countries in the west but if you live in the US with your family and also want to come to Pakistan and work here for some time, the only way you can do that is if you have a US passport.

Many physicians from my generation that got their US passports came to Pakistan and actually built their own hospitals to work in. Why US trained doctors were not welcome in government hospitals is a story for another day.

For many years, quite a few Pakistani-Americans carried a US passport and would get multiple-entry five-year visas to visit Pakistan to see their families. But then the Raymond Davis affair happened and the National Assembly wanted a list of all US nationals with Pakistani visas.

Then onwards, Pakistani consulates in the US pressed Pakistani-origin US passport holders to get a National Identity Card for Oversees Pakistanis (NICOP) instead of a visa. And so, suddenly, all these US passport holders from Pakistan became dual citizens!

Holding a NICOP had many advantages, you could have a local bank account, own property in Pakistan and do many other things, including becoming active in local politics though not contest elections. And holding a US passport you did not have to keep going back to the US to fulfill green card residential obligations. Best of both worlds if you had enough money in the US to take care of things over there.

I strongly believe that most Pakistani dual citizens of any profession, if given a chance to serve in Pakistan and perform some useful service, would really love to do that.

Of course, there is a special category of people in Pakistan who do not advertise their foreign passports. This includes bureaucrats, politicians and possibly other members of the government. They leave and enter Pakistan on a Pakistani passport but outside the country travel on their foreign passports.

So now we have three categories of Pakistanis with a foreign connection. First are those that lived aboard and have spouses or ex-spouses and children still living in other countries and having a foreign passport. The second group is of foreign residents and passport holders travelling on a NICOP. The third group is of those that carry a Pakistani and a foreign passport, often surreptitiously.

The question that is then often raised is that these people all have divided loyalties and, therefore, should not hold positions of power and authority in Pakistan. And that many have taken an oath to serve a foreign country so they cannot be trusted to serve Pakistan.

Interestingly, many of those Pakistanis that have taken an oath to serve Pakistan do a rather bad job of it so it would be a bit much to expect that those similarly born and bred in Pakistan would be taking their oath to serve another country seriously.

That said, it is well-known that many first generation immigrants still hold their original identities rather close to their hearts. Many years ago in an editorial for the journal of the Association of Pakistani Physicians of North America (APPNA), I asked the question whether most of us thought that we were Americans who happened to be from Pakistan or Pakistanis that happened to live in America?

Whatever many might have said to the question, the fact is that most of the Pakistani-origin doctors living and working in the US would love to get an opportunity to come to Pakistan and serve as I did for almost seven years at King Edward Medical College/University. The caveat being that their wives and children would be properly taken care of.

So, I strongly believe that most Pakistani dual citizens of any profession, if given a chance to serve in Pakistan and perform some useful service, would really love to do that. And more importantly, they would really put their heart and soul into such service. To doubt their loyalty to Pakistan would indeed be a canard.

There are, however, two categories of dual citizens that can be accused of duplicity but not of disloyalty to Pakistan. Of these, the ones who are probably a bit more reprehensible are those that hold a foreign passport, sometimes illegally and as such do not let it be known that they have a foreign passport.

The second group that can be at best made fun of are the seekers of reflected glory. Many of them serve visiting politicians lavishly and might even handsomely contribute to political and charity fundraisers. Such people are usually quite well off and would love to come to Pakistan and feel important.

During twenty years as a senior cardiac surgeon living in a big house and driving an expensive car, I never got the respect I got in Pakistan during my years in KEMU/Mayo Hospital. When I entered the main gate of Mayo Hospital, the guard world shoo away the crowd around the gate, and when I entered my ward the entire staff stood up, wished me the day and nobody sat down until I sat down. And yes everybody called me sir. That is what many of these foreign millionaires crave.

The writer has served as professor and chairman at the department of cardiac surgery, King Edward Medical University