June Issue 2017

By | Special Report | Health/Medicine | Published 3 months ago

With drama serial Udaari, Hum TV broke the barriers hitherto fiercely guarding the issue of child-sexual abuse, but at the Hum Awards in April, emcee Yasir Hussain’s presentation of some outrageously offensive material on stage turned the series’ message on its head. Referring to Ahsan Khan’s good looks and the role of the paedophile that he played in the drama, Hussain said he wished he were a child too (the implication being that then perhaps someone as beautiful as Khan would rape him as well).

The initial response to what can only be qualified as a crime, elicited laughter from at least a segment of the audience, and Ahsan Khan’s playing along with the host’s abominable comments, spoke volumes about at least some Pakistanis response to the subject. But perhaps that is understandable – even if never acceptable. In Pakistan there exists a virtual conspiracy of silence on the subject of sex, let alone Sexual and Reproductive Health and Rights (SRHR). The fallout: rendering children even more vulnerable to sexual abuse then they may have been – all for lack of awareness. A report by Sahil, a non-government organisation (NGO) working against child abuse, stated that even by a very conservative estimate, it was assessed that at least 11 children in Pakistan are sexually abused every day. Of this, 41 per cent are boys.

Sahil reported that 97 per cent of all sexually abused children are abused more than once, and horrifyingly, 30 to 50 per cent of the time, the perpetrators are immediate family members, friends of the parents or of older siblings, or neighbours the child is already familiar with, and trusting of, and thus more vulnerable to.

Ironically, according to the publications Express Tribune, Mic, Salon and Mother Jones – all websites that report on Google trends – Pakistan features at the top of the list for countries watching the most porn, and interestingly, for watching the most homosexual porn.

Clearly, a sizeable segment of Pakistan’s population is intrigued by sex, even if it has to resort to the net to get the information (however skewed that may be) it seeks on the subject.

And what is even more disturbing, is to learn that the words most often fed by Pakistanis on porn search engines are: “Indian aunty,” “momxxx,” “brother and sister,” “children sex,” “sexy child,” “sexy children,” and “rape,” among others. In addition there are many testimonials of rape and incest that are frequently reported on assorted news sites in the country.

According to the founder of Madadgaar National Helpline, Zia Ahmed Awan, 93 per cent of all women in Pakistan experience sexual violence at some point in their lives, yet as a society we like to pretend that they grow up particularly sheltered. In reality the only thing they are insulated from is awareness regarding their own legal rights. Subjective, sometimes obscurantist, often fundamentalist, conservative interpretations of religious doctrine view any references to sex, let alone discussions on the subject, and divorce, as taboo, and marital rape as non-existent. With no knowledge of laws that could protect them, or forums where they might find some relief, and no family support because of socio-cultural traditions which dictate that, once married, women can only leave their homes for the grave, the collateral damage is significant. Domestic violence is seldom reported to the authorities or even to family members by women. They are told to deal with it themselves, because “yeh aapas ka mamlaa hai” (This is your personal issue). So they remain in marriages even when they are emotionally, physically and sexually humiliated and abused.

Sexual abuse is also rarely, if ever, disclosed by children. Like rape, it is often seen as the victim’s own fault – no matter how young or vulnerable she/he is. A case in point: the Kasur sex scandal exposed two years ago. While the crimes had been ongoing from 2006-2014, the victims, due to intimidation by the perpetrators or because of a deep sense of shame, did not report them to either their own families or to any authority figure. Many of the victims and their families kept quiet because they were told the videos made of their children being sexually abused would be made public. And when the story was uncovered, the children were subjected to such daily humiliation and threats that they and their families were forced to leave their hometowns. Many survivors lament that instead of helping the victims find justice, media and political focus on this case has made it almost impossible for them to escape the public ridicule that haunts them.

If these factors weren’t obstacles enough to file a First Information Report (FIR) against the abuser(s), reporting male rape is another legal abyss. War Against Rape’s (WAR) survivors support officer, Rukhsana Siddiqi, rues the fact that families would rather bury the incident than face the ridicule they are certain to face in police stations, courtrooms and their communities, often changing cities and their identities to protect themselves. The fact that child abuse laws in Pakistan have not included the possibility of boys being raped in its definition is testimony to the ostrich-mode our legal system has adopted. Small wonder then, how challenging reporting these crimes is for boys and men, how unlikely it is for society to believe the survivors, and how effortlessly perpetrators evade the charges made against them.

While this tragic status quo prevails, there are, however, a few efforts underway to initiate some changes and pull sex education out of the black hole it has long languished in.

The National Programme for Family Planning and Primary Healthcare was launched in 1994 to deal with SRHR issues. It started operations by hiring 10,000 Lady Health Workers (LHWs) to start work on changing the sorry state of affairs. By 1995, LHWs for the project had doubled. Currently, over 125,000 LHWs are employed under the programme, and they have been Pakistan’s first line of defence in educating the public, especially women, about reproductive heath-related topics. However, since traditionally even acknowledging, let alone discussing the issues around SRHR have been believed to encourage sexual deviancy and promiscuity, the LHWs job is not an easy one. Even when providing the most basic information related to women’s health, they often face significant cultural obstacles, being refused entry to homes and to women – who should be the primary recipients of the information they seek to disseminate. Two LHWs have been killed this year alone, all in the line of duty.

Venkatramen Chandra-Mouli, an expert in adolescent sexual health at the World Health Organisation (WHO), emphatically refutes the misconceptions surrounding the dissemination of information relating to SRHR. He states that studies have unequivocally shown that the promotion of SRHR literature and related information has significantly reduced teen and unplanned pregnancies, unsafe abortions, fatalities during birth, the spread of sexually transmitted diseases (STDs), and cases of sexual abuse among the recipients of this data. Mouli maintains that additionally, it yields an increased knowledge of gender identity, self-awareness and tolerance for other gender orientations. Given that 45 per cent of sexually abused children are between the ages of 6-15, this information could be crucial in preventing child crimes and sexual abuse.

To date biology classes in public schools only encompass external/internal fertilisation, describe the male and female reproductive organs, rationalise the need for population planning and explain the concept of STDs using HIV/AIDS as a cursory example. This information is not nearly enough in arming the most vulnerable demographic – children – in society against the multiple maladies related to SRHR that could lie in store for them.

This despite the fact that in 2010 Pakistan officially embarked on a journey that related to SRHR education in schools. In collaboration with the Netherlands-based NGO, Rutgers, Pakistan launched a programme called Life Skills Based Education (LSBE), which focused on self-awareness, consent, puberty, averting risks, peer pressure, decision-making and sexual and reproductive rights.

Gender-based textbooks were published, but even in these, only the information pertaining to the gender accessing them was available: for instance, boys were not told about the menstrual cycle and girls were not told about the pubertal changes boys experience.

Limited as it may have been in scope, the programme reached a total of 312,807 students in 1,188 schools all over Pakistan. LSBE worked in tandem with religious officials, parents, schoolteachers, and community elders – and even referenced the Quran – all of which made SRHR information more palatable to the conservative segments of Pakistani society.

One interesting fact that emerged from the findings of the programme was the fact that students and their parents generally preferred a health official imparting SRHR knowledge to a schoolteacher doing so.

Facebook is another platform through which SRHR information and knowledge can be accessed. There are secret, all-female groups, which one can only join via invite, which ensures that every member can be vouched for. And there are others. These groups are a haven for women, where they can ask for advice on in-laws, marriage, parents, friends, work environments, labour complications, pregnancies, assorted gynaecological issues, even academic problems – and sex. The groups have qualified lawyers, doctors, teachers, mothers, friends, sisters, make-up artists, authors, journalists, even chemists, on their panels. And so, alongside the frightening fallout of technology – as in the case of the facilitation of pornography – there is, at last, somewhere women can take their questions. And while this information is only available to those with access, it is, at least, a beginning.

However, there are of course, certain more dangerous issues that cannot be addressed online. STDs for example, are as much a threat to our largely young populace as they are to other societies. According to Dr. Baseer Ahmad Achakzai, head of Pakistan’s National AIDS Control Programme (NACP), 0.9 per cent of the population is infected, making it the second largest human immunodeficiency virus (HIV) positive population in South Asia. Rutgers estimates that of this, 12 per cent of the total 102,000 living with HIV or acquired immune deficiency syndrome (AIDS), are between the ages of 15-24. The stigma surrounding SRHR topics make the affliction a difficult topic of discussion, and Google is not enough to answer queries by affected people from variable social situations. To begin with, it cannot assess the taboos imposed by different cultures. The stock answer it will invariably offer: “seek help from your nearest sexual health clinic,” or “consult your doctor,” or something along those lines. And even if the requisite medical practitioners and facilities required to treat such diseases were readily available, chances are that people suffering from these afflictions would be too embarrassed to seek the help required. Due to this social stigma, many unsuspecting couples infect each other as well as their resulting offspring, hence compounding the situation manifold.

In light of the restrictive atmosphere of Pakistani society, its increasing population, incidents of domestic and sexual abuse, child marriages and increase in numbers of STDs, one can only be grateful to the handful of individuals and organisations that are risking life and limb – literally – to educate people about SRHR. A Rutgers report surmised that circumstances stemming from SRHR – or the absence of knowledge about the subject – are the number one reason for problems in the lives of Pakistani adolescents. From too many mouths to feed, to repressive gender roles, domestic violence, child marriages and sexual abuse, SRHR is the 900-pound gorilla in the room. Small grassroots organisations, such as the Pirbhat Womens Development Society arrange theatre shows to focus on sex-related issues. Bachpan Bachao, another organisation, works towards preventing child marriages in Sindh, and it is groups like these, who, along with social media, are slowly but steadily, crossing cultural barriers to tackle the epidemic of SRHR-related problems in Pakistan.

Ultimately however, it is the duty of the state to introduce SRHR curriculum in all public schools to address a situation wrought of ignorance, socio-cultural taboos and governmental apathy. SRHR can be used as a tool to combat a high population growth rate (2.1 per cent), now well over the 200 million mark, of which 22 million are out-of-school children, ongoing child labour and high rates of unemployment. Failing to address the issue has already cost Pakistan dearly, with more and more cases of child sexual abuse, gender disparity and an alarming hike in HIV infections. And it is the duty of the media to not trivialise social issues of such magnitude in the future.