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.