The other day I stepped into the emergency department of the Pakistan Institute of Medical Sciences (Pims) in Islamabad, and witnessed chaos and chilling apathy, with human beings being treated in a sub-human manner. Instead of being in a hospital, I thought I was in some den of humiliation, disgrace and criminal incompetence. The hospital, which was once envisioned as a centre of excellence in northern Pakistan, now stands as a grim monument to the worthlessness of the lower middle class in the eyes of the federal government. It is understaffed, underfunded and seriously mismanaged. It is no wonder that hopelessness compels countless ‘animals’ to flee the country in search of dignity and humanity. When we buy medicines from reputable pharmacies, we often notice that their prices as well as manufacturing and expiry dates are rubbed off and reprinted. Who has authorised pharmaceutical companies to set prices at their own will? Illegal repa-ckaging or relabelling of medications poses significant risks to public health and safety. Alarmingly, tampering with prices and expiry dates raises serious concerns. The relevant department should monitor the activities of its drug inspectors, and make them visit medical stores and pharmaceutical companies at least once a month. Strict action should be taken against all concerned. This is with reference to the editorial ‘Climate realities’ (Nov 8). An often neglected aspect of outdoor air pollution is its broader impact on the air pollution indoors, which can be worse because it contains pollution from the outside along with additional fumes generated indoors. How many workplaces, universities, schools or hospitals have monitors to regularly check indoor air quality, and the capacity to take measures to address this rapidly growing issue?