Tuesday, September 28, 2010

Burying our Heads in the Sand

Contrary to common belief ostriches do not bury their heads in the sand when faced with apparent danger. According to experts at the San Diego Zoo when faced with an unavoidable threat an ostrich, “…flops to the ground and remains still, with its head and neck flat on the ground in front of it.” The point here is not to discuss the unique behavior patterns of ostriches, but to establish that there is an element of pragmatism inherent in the way these over-sized birds deal with danger.

Sadly, however, we Pakistani’s have a decidedly different and less practical way of addressing the many problems our nation is currently suffering from. Rather than tackle a particular issue head on and delve into its context, we prefer to run around in circles, indulging in unproductive debates around the merits of an issue, never realizing that this approach serves to only aggravate the problem at hand. This tendency is apparent in the prevalence of conspiracy theories throughout Pakistan regarding the causes of religious extremism that have, to a great extent, prevented society at large from recognizing terrorism as domestic problem with primarily localized solutions.

This tendency is also responsible for the ignorant way in which our society and government have responded to the burgeoning sexual health problems of the population which have been brought into focus by a “population explosion” that has added to the strain on our already out-stretched state structures. This sexual health crisis –after years of being ignored on a social and institutional level –has attained critical mass, so to speak. It has severely impacted the lives of a majority of the population –especially women, children and adolescents –and cannot be ignored any longer, especially in light of international recognition of the link between promotion sexual health and reduction of poverty in developing countries.

In terms of exposure to sexual health risks, the state of affairs of women in Pakistan is by far the worst and is caused by the pervasion of discriminatory gender norms that perpetuate gender inequality in society. Gender Inequity, which is defined by the Sloan Work and Family Research Network, of Boston College, as a, "A social order in which women and men share the same opportunities and the same constraints on full participation in both the economic and the domestic realm", is reflected in Pakistan by the fact that only 33% of women (10 years and older) have completed primary education and the total number of employed women is nearly four times less than that of men. Discriminatory gender norms –which restrict mobility, societal representation, and access to health and education services for women –have the combined effect of objectifying women (as means of reproduction, housework and sexual gratification) and institutionalizing gender inequity in Pakistan.

In countries where women have to survive and function in the midst of such circumstances on a daily basis their sexual and reproductive health and rights are likely to be blatantly disregarded. For instance, the existence of mobility restrictions on women not only severely limits their participation in the economy and society in the long-run but is also used as socially justifiable pretext for violence against women in Pakistan. However the primary factor of gender-based violence is the objectification of women in Pakistani society especially rural areas, where an overwhelming majority of such cases are reported. It has been reported that women are arbitrarily bludgeoned to death by male relatives for reasons as trivial as not serving a timely cup of tea. The perpetrators of such violence are not likely to feel much of a moral twinge for their actions, as the notion of social control of women –no matter how repressive –is deeply ingrained in their minds due to the environment they have grown up in. They often get away scot-free thus giving them the resolve and experience to add a bit of ‘creative flair’ to their brutality: amongst the 1321 instances of gender-based violence reported in the first quarter of 2008 alone there was an overwhelming number of cases of women being buried alive, tortured, gang-raped and burnt with acid. Similarly, the poor access to opportunities in education and gainful employment for women, and their socially-defined role as objects of reproduction is the main cause behind the 83 maternal deaths that take place in Pakistan, on average, every day. Further, it is estimated that over 80% of these deaths occur due to wholly communicable causes such as the fact that only 34% of all deliveries are attended by trained health professionals –that derive from poverty, illiteracy and gender imbalances present in our society. Regretfully, the grim picture painted by these facts is hardly given the attention it warrants by both the media and civil society.

Sadly, women are not the only demographic that is exposed to increased sexual health risks in Pakistan: the sorry sexual health state of adolescents in Pakistan is undeniable and has been highlighted consistently by the Ministry of Youth Affairs as an area of action, although little has been done in this regard. And just as the sexual ill-health of women is intrinsically linked with gender norms and cultural practices, an analysis of the root causes of the poor sexual health state of young people in Pakistan also reveals the existence of cultural norms as a key factor in young people’s prevalent sexual health status. As a result of these cultural norms –which disapprove of open discussion of sex and sexuality related issues in all spheres of public life to protect the “moral fabric” of society –the youth of Pakistan are not provided age-appropriate sexual health information through responsible channels. According to a research study, conducted by the World Population Foundation, on the “Status of Sexual Health and Rights of Young People in Pakistan”, this puts young people at increased risk of, “…abuse, exploitation and disease.” Thus it is not uncommon for young people to indulge in a number of risky sexual activities –such as having unprotected sexual debut with sex-workers –that have debilitating impacts on their sexual, mental and emotional well-being. Another concerning effect of the aforementioned cultural norms is to provide legitimacy to the denial of sexual and reproductive health services to young people with blatant disregard to their sexual well-being and needs. This is reflected in a research study, conducted by the World Population Foundation, on the “Status of Sexual Health and Rights of Young People in Pakistan”, which concludes that the right to healthcare and health protection is amongst the four most infringed sexual rights of young people in Pakistan. And despite the strong case that can be made for provision of sexual and reproductive health education and services to the youth, there has been strong social opposition towards such ideas in the past: Dawood Public School of Karachi was closed down by the Ministry of Education in August 2009 for providing sexual health education to its secondary level students, after pressure exerted by right-wing groups. It is highly likely that sexual health counseling and services will also evoke a similar response.

Hence, it is clear that the sexual health and rights status of the Pakistani population –particularly women and children –is one that cannot be ignored for longer. The fact that the prevalent situation derives from ignorance and out-dated cultural norms and practices make it imperative upon us to extract our heads from the sand and begin open, respectful and informative discussions about sexual health rights issues. This will not only assist the restructuring of the cultural order to become more responsive to the needs of women and children, but will also provide the added advantage of making civil society an important stakeholder in the integration of sexual and reproductive health rights throughout Pakistan. The latter outcome, in particular, will have a significant bearing on the success and sustainability of all governmental and non-governmental efforts in the supply and demand mechanisms of the sexual health services sector.

In the Land of Heer, Sohni and Sahiban: The Correlation between Gender Inequity and Women’s Health

“Once a daughter of the Punjab did weep and you poured out songs of lamentation
Today a thousand daughters weep, O Waris, but who is there to listen?”
–Amrita Pritam
There was a time, in this land of the Pure, when celebrated poets like Waris Shah immortalized the beauty and substance of the female spirit in soulful Punjabi verse. The tales they told –of Sohni, Sahiban and Heer –were recounted perennially, in villages and in cities, around the warmth of a fireplace in the winters and under the shade of Banyan trees in the summers. That time, regretfully, is part of a bygone era. Today, as a result of the moral and cultural discourse of the country being hijacked by an intrinsically myopic and patriarchal interpretation of Islam, women have been reduced to little more than objects; to be seen but not heard. In terms of numbers this poor societal status granted to women in Pakistan boils down to a situation where only 33% of women (10 years and older) have completed primary education and the total number of employed women equaling 11.81million –65% of which are engaged in unpaid work in family enterprise –is nearly four times less than that of men. As a result women in Pakistan have become increasingly dependent on a population of males who believe that the censure and control of women is their divine, masculine right.
However as worrying as the impeded social and economic development of Pakistani women may seem, the fact that their exclusion from education and employment has more immediate and detrimental effects on other, indirectly related aspects of their lives –such as their physical and reproductive health –is a cause of greater concern.
Although the physical and reproductive health of most women in Pakistan –except a select few –is in jeopardy it is rather shocking to note that pregnant mothers are not exceptions to the rule; the rule that justifies discrimination against women in all spheres of public and private life, regardless of the consequences, on the basis of perceived Islamic cultural norms. Ironically, in this respect the guardians of our “Islamic culture” (who are, by and large, male) are in gross violation of authentic Islamic tradition –which grants a special, elevated status to all mothers. However, regardless of religious teachings, maternal mortality is a human rights issue of vast proportions, with a total of 82 maternal deaths occurring in Pakistan, daily. Furthermore, it is estimated that 80% of these deaths occur due to largely preventable reasons –such as the fact that only 34% of all deliveries are attended by trained health professionals –that derive from poverty, illiteracy and gender imbalances present in our society.
Regretfully, however, the health problems faced by Pakistani women are not just limited to increased risk of death or complications due to childbirth. Our country is home to a host of loathsome cultural practices such as “kari” which justify severe and often fatal violence against women who allegedly violate family “honor”. With the existence of such brutal cultural practices it is hardly surprising that violence against women is rampant and perpetrated under a broad range of pretexts – ranging from attempts at sexual coercion to reasons as trivial as not serving a timely cup of tea. Even more concerning is the fact that such instances of violence against women are provided complete legitimacy under the garb of culture and religion: a Senator, Mir Israrullah Zehri, who is now a member of President Zardari’s cabinet, rather self-righteously stood up in the Balochistan Senate and defended the custom of burying women alive as a “Baloch tribal custom” which should be “respected”. With this audibly asinine pat on back provided to the perpetrators of gender-based violence by our esteemed cabinet minister it is no wonder that 1321 instances were reported in the print media in the first quarter of 2008 alone. Assuming that this trend has neither increased nor decreased over the years we can expect a total of 5284 cases of gender based violence in each successive year. And while this figure is slightly lower than the 6000 US and coalition soldier deaths –in their joint occupation of Iraq and Afghanistan –one would assume that is far more preferable to take a bullet in the head than to be buried alive.
Hence it is clear that the plight caused by the exclusion of women from social and economic systems cannot be ignored any longer especially in light of the adverse effects this has on women’s health prospects. Meaningful female involvement in society is necessary if Pakistan is to meet the human development targets it hopes to achieve in the future. And though NGO’s such as the World Population Foundation and the Aurat Foundation and government agencies such as the Ministry of Population Welfare and Ministry of Women Development are doing meaningful work at the policy and service delivery level with regards to improving overall physical and reproductive health of women in Pakistan, their coordinated and individual efforts should focus on alternate approaches –such as male involvement in the process of female empowerment alongside advocacy to increase female representation in society –which address the root cause of the prevalent poor health prospects of women in Pakistan. This approach will be far more effective, in the long run, than curative intervention measures such as setting up women health clinics, mobilizing Lady Health Workers and setting up domestic violence shelters.
An edited version of this article was printed in Dawn, issue of 1st August, 2010.


“Black holes are places where ordinary gravity has become so extreme that it overwhelms all other forces in the Universe. Once inside, nothing can escape a black hole's gravity — not even light.”

The situation Pakistan finds itself in currently could be rendered akin to being sucked into a supermassive black hole. And I’m not just being dramatic here. The fact that we face a myriad of problems on a multitude of fronts is hardly open to argument: a brutal tribal insurgency, endemic corruption and economic instability all compound the gravitational forces that are pulling us closer and closer to the event horizon. With issues of such existential proportions playing out in the foreground it is only natural that problems with apparently less severe implications on our nationhood –such as human rights issues –are dismissed as mere background noise. However, such issues have the potential to manifest into problems with nation-wide implications, provided the requisite space to do so. As such, due to a combination of many factors adolescent sexual and reproductive health (ASRH) issues have been ignored for too long; and compounded by the fact that Pakistan is currently housing the largest youth cohort (ages 10 – 24) in its history (estimated at 54.2million), have wrought a situation with severe implications.

As a society that invokes social propriety norms to banish all discussion of sex and sexuality from spheres of public discussion to protect its ‘moral fabric’, it is rather ironic that these norms have put the youth in a position that is hardly morally acceptable. Sexual and reproductive health (SRH) issues are hardly discussed outside the context of private and public sector family planning services for married couples. Additionally, in the absence of sexual health education in schools, important stakeholders in the lives of young people, such as parents and teachers, are also hesitant in discussing such issues with young people.
The problems that arise from this aforementioned social denial of ASRH knowledge and rights are most severe when experienced by children before the onset of puberty, mainly because of the vulnerability and impressionability that characterize the youth at this particular stage in their lives. More often than not pre-pubescent youngsters lack the necessary knowledge and life-skills to protect their bodies from the indulgent appetite of sexual predators. The ill-fated victims of such wanton depravity have to deal with the consequences of their fate for the rest of their lives.

The severity of the problem is only exacerbated by the fact that there is an evident lack of will on part of the relevant authorities to stop sipping chai and munching on jalebis and, possibly, do something. For instance, despite becoming a signatory to the UN Convention on Rights of the Child in 1990, successive Pakistani governments have failed to enact legal provisions that comprehensively protect children against sexual abuse. Existing laws under the Pakistan Penal Code provide that any sexual violence to a child is punishable by up to two years only, whereas, under the same law, sodomy is punishable up to a maximum of ten years. Clearly someone needs to help the government get their priorities straight. Maybe they aren’t aware that in 2005 a “grand” total of 1719 cases of child sexual abuse were recorded. And those are only the ones that made it to print!

Sadly, the sexual health problems of the youth don’t disappear after puberty. Infact, the numerous problems this cohort faces paints a grim picture for their future. The ASRH knowledge deficit plays a part after puberty as well. According to the study on “Status of Sexual and Reproductive Health and Rights of Young People in Pakistan”, conducted by the World Population Foundation, “...puberty begins in panic for most young people, since they are provided no prior information regarding Sexual and Reproductive Health.” A lack of sexual counseling services in schools and clinics only adds to their plight. Lacking proper knowledge and skills to deal with their own sexuality, the youth are also prone to engaging in a number of unhealthy sexual practices that have adverse health outcomes. More often than not these sexual acts take place without adequate protection in the form of condoms. This puts adolescents at high risk of contracting HIV/AIDS and other STD’s. A grim picture, indeed!

In a nutshell, it’s “two minutes to Midnight” and we have yet formulate a multi-faceted strategy that addresses these numerous problems on a national scale. Such a strategy is necessary if we are to prevent the youth from plunging further into the seemingly endless depths of a black hole that our own attitudes and actions have created for them. Once again, I am not being dramatic, although I wish I were.

This article was printed in Dawn, issue of 18th July, 2010.

A Song for Our Fathers

A little over six decades after Independence, a momentous struggle which ended in the long sought after freedom from our colonial masters, another battle is underway. However, rather than being fought in the theatre of political emancipation, this struggle is taking place in the hearts and minds of people. And just as any struggle can be characterized by the relationship between oppressor and the oppressed, this endeavor is a slave to the same dynamics. And in this way oppressor and oppressed are locked in a brutal slow-dance, leaving broken souls in its wake, until something gives.
The draining Lahori sunlight was cut into thin strips by the austere blinds that draped the windows as the family settled in their respective positions at the family table. Like any other middle class household with young children, the disquiet surrounding their collective activity was calamitous yet heart-warming. The mother silently fusses over the table setting, dedicating herself to her task with the resigned determination so many other faceless women have had to show in her position, as her children rollick about with the enthusiasm and carelessness that is expected of them. And whilst her children blissfully revel in their universe of candy canes and unicorns, the silent mother anxiously awaits an arrival; an arrival potentially beset with a whirlwind of unspoken expectations and unilateral unease. However, in spite of her muted apprehensions, she hoped –much like Anarkali would have hoped for a loose brick somewhere, anywhere within the walls of her ill-fated romance –for today to be the day. The day she finally gets to hear a few elusive words of appreciation from the person who mattered the most in her life; the person who had to matter the most. And just as she was on the point of being consumed by these troubling thoughts she heard keys jangling in the front door. A pall of silence descended upon the house: the once boisterous kids, roughhousing like a litter of pups, now quiet. Her husband, the father to her children, had arrived.”Is today the day?” He said.

Elsewhere, in a small rural hamlet situated on the rich, alluvial plains of the Indus, 90miles south of Lahore, a young girl was busying herself over a book containing the marvels of the English alphabet. As she furrowed her eyebrows in concentration she could not help thinking of a future, in which she envisioned herself as a nurse in the Basic Health Unit, situated in the main bazaar of her village. She thought fondly of how these letters, so simple in form, would open up an avenue of new possibilities for her and her family. No time for daydreaming now, she told herself. The wonderful future she pictured in her mind’s eye was far beyond the reach of her feeble arms now. She was almost of school going age. She would, no doubt, have to master the work at hand to enroll in the local government primary school, which was the first step in a long journey that would culminate in the realization of her dream. Of course, she would also require her father’s proverbial stamp of approval if she had any hope of realizing her dream. And although only a few of her playmates had been lucky enough to convince their fathers to send them to school, she had high hopes. A slight smile colored her features as she thought these lofty thoughts. And as fate would have it, at that very moment her father walked into the room. “Bring me some water, my child. Your father has had a tiring day in the fields,” his voice resounded. With a jolt she got up and attended to her fathers request. This would be the perfect time to bring up her plan, she thought to herself. However, almost as if he could hear her thoughts, his gaze fell upon her open book of alphabets. “What is this nonsense?” he inquired, slightly irritated. “Don’t tell me you’re trying to learn how to read? Do you not know that as a girl, the only thing you should be doing is doing the household chores and…”
“But Abbu, I want to become a doctor when I grow up,” she interjected.
“NO! You are my daughter, and you shall obey…” She had a feeling that she knew what he would say next and her heart sank.
Although the two situations related above could not be more diverse in terms of social and cultural setting, it goes without saying that there is one glaring similarity between them. It is sad to note that such a similarity exists in a remarkable majority of Pakistani households, whether they are urban or rural. The song that could have flowed from these suppressed voices is inaudible. Their future looks bleak. On this auspicious day I beseech our nation of fathers to let these songs –of beauty and of life –to ring true and free. It is in your hands. For what is the morning without the mellifluous sound of a nightingale, regaling us with its heartfelt ballad.

This article was printed in Dawn, issue of June 20th, 2010.