By Jonathan Landay in Karachi, Pakistan

For the people of Chanesar Goth, Pakistan's Feb. 18 elections are about the devastated concrete shell that hulks in the center of their blighted neighborhood.

The squat, one-story structure was built to house a health clinic by the government of Sindh Province in the 1990s when the Pakistan Peoples Party of assassinated Prime minister Benazir Bhutto ran the province.

Karachi's municipal government was then supposed to operate the clinic. Its services are desperately needed by the 50,000 souls who inhabit Chanesar Goth, a noisy ghetto of narrow alleyways where children gambol between open sewers and fetid piles of rotting garbage.

But the clinic's staff and equipment never arrived. The way residents tell it, that's because Chanesar Goth is a PPP bastion while the rival Muttahida Qaumi Movement runs the city government.

Their contention is not hard to believe. Patronage is the grease of the rough-and- tumble politics of the slum worlds in which many of the poor of Pakistan and other developing countries live.

So the small concrete building sat, empty. Local drug addicts began using it as a refuge in which to smoke hand-rolled cigarettes laced with cheap brown heroin made from Afghan opium. Residents gradually stripped off the doors, windows and anything else of use that could be pried loose and carted away.

Concrete lumps, chunks of cinder block and mounds of trash now litter the ground around the concrete corpse. The holes once occupied by windows and doors sit dark and empty, like the eyes of the addicts who creep inside to inhale their poisonous smokes.

Residents hope that the elections will bring in a PPP-run provincial government that will revive the project as a reward for their neighborhood's loyalty.

That, however, is far from certain.

Several miles away from Chanesar Goth is Pakistan Chowk, whose allegiance to the MQM screams out from the sea of party flags and banners affixed to streetlights and rooftops and strung across the narrow streets.

I asked a shopkeeper about assertions by Chanesar Goth residents that the municipal government only channels funds into projects and services in the neighborhoods loyal to the MQM.

He scoffed, nodding at the mountain of garbage that has been building, awaiting collection by city sanitation workers, for two years.