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Women should leave the hospital with a contraceptive

Pakistan must ensure that women are included in the family planning process

 Published: September 26, 2019

An Internally Displaced Pakistan woman from the North Waziristan tribal region carries her sick child. PHOTO: AFP

By Farahnaz Zahidi

Her backache is better, and she is feeling relieved for more than one reason. An hour ago, Azra got an Intrauterine Contraceptive Device (IUCD) which she calls a Challa (ring) inserted, with her own free will; the IUCD will potentially give her a break of five years from conceiving a child. This 30-plus years old mother of three, who does not know even her own exact age, knows well now that to remain healthy to look after her three children, and to possibly give birth to healthy children in the future, her body needs a break. Azra had come to the Naudero Rural Health Centre (RHC), District Larkana, Sindh, complaining of bleeding since eight days. This was her second miscarriage. The medical staff, after an ultrasound, told her she had been pregnant since nine weeks and her pregnancy could no longer be sustained. As her dilation and curettage (D&C) was performed, she also got the IUCD inserted. “My husband did not want me to use a permanent method of contraception as we may want to have children after a gap of some years,” she said. Muhammad Panjal, her husband, and Azra herself, mutually decided to go for a long-term contraceptive, an IUCD in their case. “One of our focuses presently is to encourage women to go for long-term contraceptives, like we did for Azra,” says Naghma, working for Pathfinder as a Technical Supervisor for the district of Larkana for Family Planning (FP) related initiatives. Azra is all praise for the staff at RHC who made her understand what was best for her and her family. “We counsel the patients mostly during the antenatal visits; this gives us enough time inform them about the various choices of contraceptives, their benefits, as well as side-effects if any. The decision, then, remains with the patient; she chooses, after discussing with her family, the FP method best suited for her,” says Dr Erum Siyal, working at RHC Naudero.

Dr Siyal explains why Post-partum family planning (PPFP) is a key focus for FP in areas like Naudero. “Once they leave the hospital after delivery, they rarely come back. Reasons are many. Lack of mobility, lack of resources to pay for transport to reach the hospital, lack of awareness – these are all deterrents,” she says.

Dr Azra Ahsan, a gynecologist and obstetrician with a special focus on family planning and maternal health, terms the focus on PPFP as being “extremely important’, adding that it is all the more important because the Contraceptive Prevalence Rate (CPR) is insufficient for effective family planning, which means people are not using enough FP methods. “The silver lining, however, is that women are coming to health facilities to have their babies in increasing numbers. This is a moment to seize and an opportunity not to be missed,” says Ahsan.

Grass root level initiatives like Naya Qadam, implemented by Pathfinder International, have an increased focus on access to post pregnancy family planning. Naya Qadam is a consortium of six organizations – Pathfinder, Aahung, Greenstar Social Marketing (GSM), National Committee on Maternal and Neonatal Health (NCMNH), IPAS and Shirkat Gah – working in six districts of Punjab and Sindh provinces. The objective is to increase access to high quality PPFP with a focus on young women (age 15-24) in Sindh and Punjab. Naya Qadam is introducing a multi-sectoral, counseling-centered, integrated life cycle approach to post-pregnancy service delivery. It aims to lessen the widening gap between service availability and unmet need by upgrading lady health workers, community midwives, and lady health visitors’ (LHVs) capacity to offer services through redesigning antenatal care as a lever for taking full advantage of the postpartum moment to offer FP.

Women like Azra go back to their villages after getting contraception, and become informal activists of FP, convincing their female friends and relatives to do the same. According to Dr Siyal “the awareness has increased and continues increasing at a fast pace”.

57-years-old Salma John from Jamshed Town, Garden East Karachi, has been working as a Lady Health Worker (LHW) since 2003. “Contraception should be carried out within 24 to 48 hours after delivery or DNC, and within ten minutes after the placenta is expelled. That is the best time to do it, otherwise most women do not come back for follow up.” John shares that condoms and pills still remain the most popular methods of contraception. Examples of modern methods include the pill, intrauterine devices, implants, injectables, and condoms. “With the help of Naya Qadam’s training sessions, we learn something new every time,” says, John, explaining how LHWs stay abreast with the latest developments in the field of FP. Each LHW, in John’s area, covers a population of 1000, which means she has to visit 100 to 150 houses. “Attitudes vary greatly across ethnicities and demographics matter a lot,” says John.

Experts predict that by 2030, Pakistan’s population will swell up 245 million, making it the 4th most populous nation in the world. According to the latest Pakistan Demographic and Health Survey (PDHS) 2017-18, 17 per cent of currently married women have an unmet need for family planning. If all married women who want to space or limit their children were to use a family planning method, the contraceptive prevalence rate (CPR) would increase from 34 percent to 52 percent. Only 34 percent of currently married women are using a contraceptive method either to space or to limit births.

Zahida Parveen, an LHW for District Okara, Punjab, sounds very hopeful. “Over 20 years as an LHW, I have visited thousands of houses, often visiting 15 houses a day. And I have seen how the awareness about family planning has grown exponentially. Initially people were so skeptical of LHWs visiting and counseling them, especially about FP, that they would not even touch the Paracetamol we sometimes gave them for pain or fever. The mother-in-laws in particular felt we are part of some sinister scheme to stop their daughters-in-law from having children, and want to stop their future generations from coming into this world,” she says. Now, she happily reports, even long-term contraceptives like IUCD are accepted as a choice by many women. The training she and other LHWs are receiving by Naya Qadam has taught them about newer forms of contraception too, like Levonorgestrel Implants – implantable subcutaneous contraceptive capsules – sold under brand names like Norplant and Jadelle. “It has taken years to win over the trust of these families; now they are open to the counseling services we provide for them,” says Parveen.

Social attitudes and changing mindsets remains one of the biggest challenges. Based on her experience of more than 15 years, John feels that attitudes towards FP have improved. “Now women are becoming aware enough to themselves giving permission to get contraceptives. However male involvement is still deep-rooted, as are the pressures of in-laws. One of the biggest tasks of LHWs is counseling the families,” she says.

“Women are raised in the community to accept patriarchy and gender inequality, letting go off their rights to choose for themselves. This further empowers men and other household figures, like mothers-in-law, to decide about potential size of families,” says Tabinda Sarosh, a women’s rights and reproductive health advocate, and currently the Country Director of Pathfinder International. In many families, desire to have sons results in increase in family size, and men make most decisions on health, economics and rights of family members, yet do not take responsibility for contraception, she explains. As someone who is running projects with the Government of Pakistan for quality services of FP, Sarosh feels that the most important solution to the problem is re-construction of the existing social and gender norms, by working from policy to communities, through multi-level and multi-sectoral interventions. “Combining health, education, gender, and micro-finance interventions to create an enabling environment for women to get equal opportunities in education, employment and health related decisions” is the baseline solution in her opinion.

Provincial governments are showing an upward swing, and the thrust on FP seems to have started to show improvement.

Minister for Health, Punjab, Dr Yasmin Rashid, is focusing especially on two areas as priority – Maternal Health and Child Health – says Dr Akhtar Rasheed, who works as Technical Lead for Family Planning and Nutrition, government of Punjab, assistant the province’s Minister for Health as Adviser. “We want family planning to become a means for improving maternal health by ensuring that women have a gap of at least three years between having children,” he says. 1195 basic health units are working 24/7 in Punjab, in addition RHCs, DHQ hospitals, and tehsil-level hospitals. “Our focus is on facilitating antenatal care and visits, and use this opportunity to counsel the women to go for long-term family planning,” says Rasheed.

Focal person of the Sindh FP2020 and Technical Adviser of the Costed Implementation Plan’s (CIP), Dr Talib Lashari, says that the CIP’s implementation in the province of Sindh is underway at a fast pace. The province of Sindh became the first province to come up with a roadmap, the CIP, for achieving FP2020 goals. “Our focus is on increasing and enhancing existing services. We have 72 Reproductive Health Service A Centres (RHS-A) located in DHQs that supply a full range of all kinds of contraceptive methods. A new choice among contraceptives that has been approved is an easy-to-use subcutaneous contraceptive injection that women can give to themselves to prevent pregnancies for short term like 3-months; it is called Sayana Press. This has been introduced in 17 districts already and will be introduced in another 12 districts by December. Our aim is to increase the CPR to 45% by 2020. Post the release of the latest PDHS, research conducted by departments under the CIP Secretariat shows that the CPR has already reached 34%. But to reach our target, we will have to work two fold,” says Lashari.

Both the Sindh government and Punjab government provide contraceptives free of cost. In Punjab, the government even gives women the facility of free pick up to reach the hospital for deliver free of cost to encourage them to deliver at proper health facilities.

What is a fresh spin on the strategy for FP is that to increase the contraceptive prevalence rate (CPR), the government of Sindh is now focusing on urban migratory population and slums. “For this the Karachi Urban Plan is being made. Part of the efforts is to counsel migratory communities in their own language. We are focusing on PPFP, and 1758 doctors are being trained across Sindh for it. Tertiary hospitals are also being looped in for FP efforts. Trainings are also being conducted for helping insert devices that release levonorgestrel for birth control,” says Lashari.  He adds that in Sindh the political commitment is a hundred percent. However, he accepts that while there are opportunities, there are challenges too, and much needs to be done. “We have a window of optimism due to the above steps being taken.”

“When a woman goes through the often traumatic experience of a miscarriage, an abortion, or childbirth, and especially if her pregnancy was not a desired one, she is more receptive to the idea of getting PPFP. By PPFP, I mean both post-partum family planning and post-pregnancy family planning. That is the best time to make sure she goes home with a contraceptive,” says Rasheed.

While modern methods are being introduced and both public and private sectors are working on increasing awareness about FP as well as working on supply of contraceptives, there is little that can be done to bring women back to the hospital once they leave. Thus, post pregnancy family planning remains the key. “The women should not only leave the hospital with a baby, but with a contraceptive too,” says Ahsan.

An abridged version of this article was published in The Express Tribune here.

Let us talk numbers – Contraception in Pakistan

For Pakistan to climb the ladder of development indicators, the issue of family planning needs urgent attention

Let us talk numbers
Only 34 percent of married women are using a contraceptive method.

While we are at it, let us talk more numbers. According to the latest Pakistan Demographic and Health Survey (PDHS) 2017-18, 52 percent of currently married women age 15-49 in Pakistan have a demand for family planning (FP), 19 percent for spacing births, and 33 percent for limiting births. Only 34 percent of currently married women are using a contraceptive method either to space or to limit births, and therefore have fulfilled their need. However, 17 percent of currently married women have an unmet need for family planning — 10 percent want to space and 8 percent desire to limit births but are currently not using any contraception. If all married women who want to space or limit their children were to use a family planning method, the contraceptive prevalence rate (CPR) would increase from 34 percent to 52 percent.

Humans require developed ecosystems to survive and thrive, something that we are unable to provide to more than 220 million people. Of the 17 Sustainable Development Goals (SDGs), Pakistan is lagging behind at most. According to UNICEF, 23 million children between the ages of 5 and 16 are out of school in Pakistan, a whopping 44 percent of the total population in this age group. There are some five million children between the ages of 5 to 9 who are not in school, making it the world’s second-highest number of out-of-school children (OOSC) at the primary level. Not just this but also that gender-wise, boys outnumber girls at every stage of education. In Balochistan alone, 78 percent of girls are out of school. For every 10.7 million boys that are enrolled at the primary level, 8.6 million girls are enrolled, and dropouts of female students remain high. Health experts say that over 44 percent of Pakistani children under five years are stunted due to chronic malnutrition.

It is not that Pakistan is not working on these issues. Yes, clearly, the work is not enough, but there is something more to the failing state of our social indicators. That is, perhaps, the missing link we do not see enough work being done on — family planning. The strapping Pakistani youth in such high numbers could be Pakistan’s asset; they are, instead, Pakistan’s Achilles heel. The nation has to not just feed the 220 million plus people. It also has to provide opportunities for growth and development so that Pakistani people can tap into their potential for economic prosperity of themselves and of the country.

The dots have been joined. Why, then, are we failing at it?

Lack of political will, and perhaps realisation among the upper echelons of power regarding the importance of mitigating this increase in population has been a consistent issue. Earlier this year, the Ministry of Health formulated an action plan for population control. The draft shows that the government is aiming at obtaining universal productive health services by 2025. The buck stops at the National Task Force on Population Control, headed by Prime Minister Imran Khan. But the real test is not just the approval of such action plans, but actually the implementation. The plans have been multiple but the implementation has clearly not been enough. When a country’s biggest issue has been its national security, followed if not preceded by layered and debilitating economic crises, family planning seems to be a lesser important challenge. In reality, it is one of the biggest ones.

What the proposed law is doing is updating an old piece of legislation with some new principles of human and women’s rights and ensuring that processes are made easier and more streamlined and that the suffering of a significant number of people in their country is reduced.

Healthcare persons and experts working at the grass root level cite many potential issues. While antenatal care and visits from a skilled healthcare provider may have improved, there is still much to be done. Midwives and lady health visitors can play an imperative role in this, and it is these programmes that need to be strengthened through their training and capacity-building. Perhaps this is why modern contraceptive use by married women has stagnated over the last 5 years, with 26 percent of women using a modern method in 2012-13 and 25 percent in 2017-18, according to the PDHS. Lady health workers play a major role in dispensing injectables, oral pills, and condoms to women, 18 percent, 26 percent, and 15 percent respectively.

Modern methods include injectables, intrauterine devices (IUDs), contraceptive pills, implants, male condoms, the standard days method, lactational amenorrhoea method, and emergency contraception.

69 percent of unplanned pregnancies end in induced abortion in Pakistan, states a recent study by Guttmacher Institute titled “Adding It Up: Costs and Benefits of Meeting the Contraceptive and Maternal and Newborn Health Needs of Women in Pakistan”. The study further informs that fully meeting married women’s need for contraception would lead to an estimated reduction of nearly 1,000 maternal deaths annually.

Contraceptive discontinuation, myths surrounding use of modern contraceptives, fear of side effects, lack of awareness, an absence of decisions made mutually by the couple without interference of mothers-in-law and societal dictates — the reasons are multiple.

World Contraception Day falls on the 26th of September. It is a reminder that for Pakistan’s well-being, much needed impetus for the issue of family planning is the solution. It is only then that Pakistan can hope to climb the rungs on the ladder of development indicators.

http://tns.thenews.com.pk/let-us-talk-numbers/#.XZGtB0YzbIU

 

NON-FICTION: THE AESTHETIC MYSTIC

Updated August 04, 2019
A photo by Joseph Hoyt and calligraphy by Ziaur Rehman Khan and Ali Alam | Images from the book
A photo by Joseph Hoyt and calligraphy by Ziaur Rehman Khan and Ali Alam | Images from the book

Mirza Asadullah Khan Ghalib and Allama Muhammad Iqbal in a more regional context, and William Shakespeare in a more global one, would be turning in their graves in this era of social media. So many of the couplets and verses attributed to them were never written by them. But more than any of these greats, it is the words of Rumi — or not, actually, the words of Rumi — that are shared callously and confidently. Translations of alleged excerpts from the Masnavi-i-Masnavi of the 13th century poet, jurist, Islamic scholar, theologian and Sufi mystic Jalaluddin Muhammad Rumi — often called Maulana when mentioned with a term of endearment — have been popularised to the point that, today, it is difficult to decipher which of the quotes in social media artworks and in coffee table books actually originated from Rumi’s pen and heart, and which are mere ambitious and fictitious attributions to him. However, when Coleman Barks, one of the most famous Western interpreters of Rumi, says that a couplet is Rumi’s, it probably is.

The works of Barks, complimenting some of the choicest images taken by photographer Joseph Hoyt, constitute The Mystery of Things: Interpretations of Rumi. Hardbound, visually delightful, and an easy and satisfying skim-through on a day when one is looking for nuggets of spiritual wisdom to answer deeper existential questions, the book touches just the right chords with today’s lover of Rumi’s works.

Hoyt’s earlier book, Afghanistan 1970-1975: Images from an Era of Peace, published in 2008, was when his photographs — based on the time he spent in Afghanistan — transitioned from being in exhibitions to taking form as a book. The Mystery of Things also started from being photographs on exhibit and are complemented by Barks’s writings based on Rumi’s verses.

Khalid Hosseini, author of the famed The Kite Runner, and Hoyt have had a long connection. Half of the proceeds from Hoyt’s first book went toward supporting The Khaled Hosseini Foundation to help with providing humanitarian assistance to communities in Afghanistan that needed it. It is thus befitting that the foreword of this book is written by Hosseini. In the foreword, he explains why photographs taken in Afghanistan are a suitable backdrop for Rumi’s verses: “Rumi’s soul was in the Afghan wind. It was in the air, in the water. You could hear it in the blind crooner’s song at a crowded street corner, in the extra beat he held the sorrowful notes, in the elegiac tremble of his voice. Rumi was everywhere. It is hardly surprising. Afghanistan is, after all, the birthplace of the great poet.” Hosseini goes on to call this book the perfect marriage between words and images.

The 44 images from Afghanistan in this book are simultaneously timeless in their human quality and nostalgic in the fact that they were captured by Hoyt’s lens in the 1970s, and thus remind one of an Afghanistan that has changed and evolved in many ways, owing to the many storms the country and the nation has weathered.

Perhaps that is something Rumi’s poetry also highlights in the human race. There is so much that is intransient in humans, owing to their inherent connection with the Divine. Yet the identity of humans keeps evolving. In this, there is much that is lasting and much that is fleeting and ever changing in humanity.

The selections of poetry are careful, and stirring, which is a quality archetypical to Rumi’s poems. Such as this quatrain:

Burning with longing fire
Wanting to sleep with my head on your doorsill
My living is composed only of this trying
To be in your presence

Another one, juxtaposed against a spectacular photograph of an amber-hued sunset — or sunrise — sky reflecting in still waters, is this classic piece of mystic poetry:

I keep asking, Who gives my soul
This increasing delight in what it does?
Who gave me life in the first place?
Sometimes I feel covered
Like a falcon mewed
Waiting inside its hood
Other times I can see
Then I get released into the sky

The art in the book is not limited to Hoyt’s photography. The sections are divided by selected verses from Rumi’s Persian poetry, calligraphed with a flow that is almost poetic, merging seamlessly into the philosophy that Maulana’s poetry offers. For this, calligraphers Ziaur Rehman Khan and Ali Alam deserve a special mention.

In Pakistan, the book has been published by the Bookgroup and the editors are Rakhshee Niazi and Sami Mustafa. The paper quality, layout and the touch and feel of the book, as well as the careful selection of the colour palette of black-and-white with greys, does justice to the content. It is a sensitively designed and printed book, with a gentle and aesthetic feel to it and not once does it overstep the boundaries of being in the periphery of Rumi’s mystic ideology. It is then safe to say that this is a layered book, in that it uses various media such as mystic poetry, calligraphy and impactful photography.

Yet another layer that may interest the Rumi aficionado is the fact that it is none other than Coleman Barks whose translations have been used as the main textual content of the book. To many, Barks’s work on Rumi has been the means to get introduced to the great sage’s poetry. To others, Barks’s work remains a debatable means for this introduction. For starters, Barks — according to some experts — is not known for his prowess of Persian, but rather as one who interprets existing translations of Rumi’s work, thus being the interpreter rather than the translator. But even if he is established as the translator as well as the interpreter, who is the target audience of Barks’s interpretations of Rumi’s work? The way Barks interprets Rumi’s poetry makes Rumi sound simply a mystic, and the image he paints of Rumi is what many have critically called a ‘non-Islamic Rumi’, whereas history has it clearly that Rumi — in addition to being a spiritual master and mystic poet — was a theologian, a scholar and a jurist of Islamic law as well. It is almost as if the mention of Rumi as a Muslim scholar has been erasedfrom his works. Perhaps today’s human craves answers to the bigger questions in poems that are connecting him or her with the Divine as the Beloved, but does not wish to alter his or her lifestyle in accordance with Islamic jurisprudence. Thus, the Rumi described in Barks’s interpretation of him is one whose only creed is love. While this is very enticing to today’s audience, how close to reality it is remains debatable.

Nevertheless, Barks’s contribution to popularising and propagating the works of Rumi cannot be taken away. This book, thus, remains an important and refreshing addition to aesthetic printed renditions of the works of Rumi.

The reviewer is a Karachi-based journalist, editor and media trainer; human-centric feature stories and long form write-ups are her niche

The Mystery of Things:
Interpretations of Rumi
Translations by Coleman
Barks
Photography by Joseph Hoyt
Bookgroup, Karachi
ISBN: 978-9695503683
120pp.

Published in Dawn, Books & Authors, August 4th, 2019

https://www.dawn.com/news/1497975?fbclid=IwAR3mgJnawPNEbV5jCUc3dnMdbjDxZUx4pJUulypP6Y7UGzlVcv_Tl5XFTxU

Making Pakistan proud: In conversation with Wajiha Pervez

Making Pakistan proud: In conversation with interdisciplinary designer Wajiha Pervez

 Published: July 15, 2019

Wajiha Pervez is a Pakistani artist, interdisciplinary designer, materials enthusiast and traveler.PHOTO: VCUarts

Pakistan has an abundance of talent, and young Pakistanis continue to make their homeland proud internationally. One such Pakistani is Wajiha Pervez, a Pakistani artist, interdisciplinary designer, materials enthusiast and traveler.

Qatar Foundation (QF), a conglomerate of academic institutions including campuses of many international universities, houses the Virginia Commonwealth University School of Arts (VCUQ). The university hosts a high-profile event, Tasmeem Doha, which hosts renowned artists and speakers from all over the world. Up until now, the board of the event only consisted of either key faculty members from the parent campus in Richmond or top local faculty. However, this year, for the first time, Wajiha has been added to the board as a co-chair of the prestigious Tasmeem, the first entirely student-led edition of the event. She is the first Pakistani to have achieved this honour.

Born in Karachi, Wajiha received her BFA degree from the University College of Art and Design, Lahore, with a specialisation in textile design. Currently living in Doha, this 29-year-old achiever went on to acquire her MFA in Design from VCUarts Qatar in 2017.

In this exclusive interview, she talks to ET Blogs about her life, her journey, and her achievements.

Why did you opt for studying design at the university level?

Growing up, I was surrounded by family members and friends who were creative. I used to watch my grandmother’s stitching and was struck at how a piece of cloth, a few strands of thread – and skill – could create something beautiful. My mom has always been my biggest support and cheerleader. I get my energy and drive from her.

Besides, I felt it was the right time – Pakistan’s fashion and design sector was coming alive. We had our own design institutes.

Also, design suits my personality. Everything is fluid and evolving in design, which means that it’s unpredictable. As a person, I’m quite comfortable with that element of unpredictability, with allowing things to evolve in their own time.

Design is not merely about clothes and accessories; there isn’t a facet of life that is not touched by design. Even the most sophisticated technology needs an element of design to make it appealing and marketable; from forks and forklifts, to hospitals and homes, a designer’s fingerprint is on almost everything you use.

In the subcontinent, high-achieving students often choose a science stream. How did you take a different path?

There is still a degree of uncertainty in Pakistan when it comes to studying anything that does not lead to a ‘prescribed path’. And my case was no exception. It took quite a bit of persuasion and arguments with my family, to convince them of my decision.

Do you feel that attitudes in Pakistan have changed for youth and women?

As a millennial from Pakistan, I would say that things have changed a lot. The youth of Pakistan doesn’t accept answers blindly; we want to know the reasons behind a decision.

As a woman from Pakistan, I feel empowered because I have been raised by women who were independent and strong; never in my family have I seen a woman not being given an equal voice as her male counterparts.

I know that there are other women who may not be as fortunate as me. But then again, I’ve also been inspired by women who have faced their circumstances and gone on to achieve what they set out to. So I think women in Pakistan are in a far better place than their mothers and grandmothers were, and they know that.

How has the fashion and design scene in Pakistan evolved?

An appreciation of the finer elements of fashion and design has always existed in Pakistan. But it wasn’t given a voice and projected out onto a platform. We didn’t give it the sort of publicity that we do now. Compared to the fashion scenes in other countries, we’re still in our infancy. We are a regional contender, but we have yet to mature, or be elevated to a position where we are a global leader. I see this as an advantage – especially for people like me. It gives us more room to explore and establish our own styles.

When it comes to design, what do you focus on?        

My special interests are in material innovation. Now I make footwear and active wear mostly and consult companies on patents for sustainable materials and technologies. I also like to explore globally-endangered textiles through contemporary materials and techniques, so that traditional textiles continue to live on. I want to continue my research in the circular economy, sustainable fashion and ethically-produced textiles. I’m also keen to put together more conferences, events and festivals like Tasmeem.

Having co-chaired an international art and design event as a Pakistani, what does it mean to you?

Today, the experience seems surreal. I met so many incredibly talented people. Incidentally, the theme of this year’s Tasmeem was Hekayat (stories) and that was apt. The participants were a combination of rising and famous designers and artists, but they were also people who had struggled to reach where they are now; to get things done, to get their voices heard. It was inspiring to learn about what it took for each person to reach where they are now. For me, that was the biggest take-away of my experience – that I helped bring these inspiring designers to Qatar, and, in turn, inspire those in Qatar.

As a Pakistani, and as a woman, what has your experience in Qatar been like?

As a woman, what has struck me as amazing was the female leadership in Qatar and the QF. Nowhere else have I seen such remarkable female leaders as I have in QF’s Education City. I have always looked up to amazing women back in Pakistan, but in Qatar, the level of female-led leadership is something else; every big institution or organisation has a female in one of the topmost positions.

In Qatar, another factor that stands out is the multiculturalism. I’m blessed to have chosen a country that respects and values people from Pakistan. And not just to me, this country gives a voice and place to people from other countries also who call Qatar their home.

What would you tell your peer group – especially women – in Pakistan?

I would say the very first thing is to define yourself to yourself; you cannot move a step forward unless you know what your heart wants. Secondly, make sure you don’t take up anything that you don’t feel really strongly about. Then, step out. Because once you know the reason, the motivation and direction finds its way and then nothing can stop you.

God doesn’t give you a challenge if He feels that you don’t have what it takes to overcome it. You need to hold firmly on to that belief, because there will be times when that will be the only thing that stops you from giving up and going back.

Any immediate future plans that you’d like to share with us?

After Tasmeem 2019, for the first time since the biennale was staged, we are taking it out onto an international platform. The Tasmeem space will be set up as part of the upcoming London Design Festival in London Design Week. I’m in the process of putting together the exhibits and merchandise for that. After that, we plan to present a talk about it in Amman in Jordan. As for my personal circular fashion research, I am devoting more time to it now and we will see where it takes me.

(All photos: VCUarts Qatar)

Farahnaz Zahidi

A writer and editor, who has worked as a Features Editor with The Express Tribune. Her focus is human-centric feature stories. She now writes as a freelancer, and works as a media trainer and communications practitioner. She tweets as @FarahnazZahidi (twitter.com/farahnazzahidi?lang=en).

The views expressed by the writer and the reader comments do not necessarily reflect the views and policies of The Express Tribune.

https://blogs.tribune.com.pk/story/85335/making-pakistan-proud-in-conversation-with-interdisciplinary-designer-wajiha-pervez/?fbclid=IwAR0pw_veB6I18bwkE1CIAGT4jz-ezY36vYKm5I1fp0tdHhwogIS8f2QS8sY

Climate Change & increase in Population in Pakistan – The Missing Link

The real paradox

While much is said about climate change and the accelerated increase in population in Pakistan, the link between the two is often overlooked

The real paradox
Pakistan’s population is expected to swell to 403 million in the next 31 years. — Photo by Rahat Dar

Juxtapose these statistics against these facts: Pakistan is the 7th most vulnerable country affected by climate change. The infamous Karachi heat wave of 2015 resulted in more than 1200 fatalities. The intensity and persistence of heat all over the country is continuing to grow. Nawabshah, Sindh, had a temperature peak recorded at 50.2 degrees Celsius in 2018, the highest temperature ever recorded globally in the month of April. According to the Inter Press Service report, Pakistan’s Battle Against Climate Change, “Pakistan has faced around 150 freak weather incidents as a result of climate change in the past 20 years: flash floods, smog in winter, forest fires in summer, melting glaciers, heat waves, landsides, displaced population, etc”. It further states the floods of 2010 affected 18 to 20 million people and flooded one-fifth of Pakistan’s land mass.

The cost of climate change is heavy on the already weak and struggling economy of the world’s 5th most populous nation. Yet, while much is written and said about climate change and the accelerated increase in population in Pakistan, the link between these two is often overlooked.

“Neglecting this link is missing the very essential point of why Pakistan is facing impacts of climate change,” says Dr Zeba SatharCountry Director of the Population Council in Pakistan. She adds that those with large households and those living in poverty are frequently those living on the margins that are affected, if not devastated, by extreme climate eventsShe adds that people with large households, as opposed to those living in poverty, are the ones that are frequently affected, if not devastated, by extreme climate events. “If you do not factor in who is vulnerable to climate change, how can you tackle issues like risk aversion and adaptation?”

“If the current population growth rate is not controlled, common sense says that the load on the current ecosystem will increase dramatically,” according to Ali Tauqeer Sheikh, CEO of Leadership for Environment and Development (LEAD) Pakistan. “What we need is a more responsible growth rate that can sustain the ecosystem. Ecosystems include health services. If they collapse, there will be a resulting increase in incidences of malnutrition and stunted children,” he says.

Sheikh shares that urbanisation is a key aspect in all of this. “Districts with less forestry, less agriculture, less vegetation and less water are the districts where poverty peaks, as does outward migration.”

Sheikh is also concerned about the rate of urban growth which is double of population growth rate. “Urban sprawling, irregular human settlements are connected to migration towards urban areas mostly from climate change-impacted areas.”

Dr Farid Midhet, a population and health expert, says: “Pakistan-specific population-related problem is migration from rural to urban areas. This results into squatter settlements without any civic facilities. Karachi’s 40 percent population lives in such areas, which have no facilities for drainage or waste disposal”.

Unfortunately, Pakistan has a semi-literate population and a largely lawless society, “which results in population overgrowth and environmental damage at the same time”. He believes that Pakistan is facing an environmental crisis, “which is probably going to worsen with time as population increase is completely unchecked”.

Dr John Bongaarts, vice president of the Populations Council, is of the opinion that given the urgency of the problem and the lack of political will, less conventional approaches to limit climate change should be given higher priority. “Addressing rapid population growth is one such policy that has thus far been ignored by the international climate community. The expected addition of several billion people to the planet by the end of this century will make it much more difficult to slow or halt climate change.” Bongaarts adds that studies show slower future population growth could reduce global emissions by an estimated 40 percent or more in the long term. “Over the next few decades, overall emissions from low income countries such as Pakistan are likely to rise rapidly because of a rise in emissions per capita from rapid industrialisation, as well as because of increasing population.”

Research by LEAD states that the geographical location and socio-economic fragility of developing countries makes them more vulnerable to the environmental, social and economic ramifications of climate change and the lack of resources and capabilities to adapt to the changes worsen the situation — people who live in poverty around the world, then, are hardest hit by climate change.

Thus, while developing countries like Pakistan are least responsible for the dramatic changes in global climate, our communities suffer the most.

“It is also a very political issue, and for developing countries, it also becomes an issue of justice,” says Dr Adil Najam, Dean of the Pardee School of Global Studies at Boston University. “My emissions, living affluently in the USA, driving 30 miles each way to work every day, surrounded by cheap oil and technological waste, are very different from the emissions of a poor Pakistani living in a remote village. Not only is the quantum of emissions different, but the type of emissions is different — the first are luxury emissions and the second are survival emissions.”

Najam feels that the poor will pay twice if their population growth remains high, “mostly because the rich — whether in rich countries or the rich within our own country — have been gluttons in usurping the resources the poor need for their survival.”

He feels that the lens through which countries like Pakistan have to view population growth is “adaptation”. “More people living in a changing climate will mean that more will need to adapt to the new Age of Adaptation. That will impose burdens of new costs on the country and, most importantly, on the poorest communities in the country. My general sense remains that we should focus on people and the well-being of people rather than on the numbers or growth rates of population.”

The answer, then, seems to lie in adaptation. Najam says that adaptation is about coping strategies — what we do to cope with heat waves or floods or melting glaciers or droughts. “Adaptation is best defined as the failure of mitigation. Mitigation is about reducing emissions. Adaptation is about developing resilience, and that is about development.”

Given that the poorest are also the most vulnerable to climate change, and that is also where the largest population growth tends to be, he feels that it is imperative to think of reducing population growth not as a strategy to reduce emissions, but as a strategy to enable people to have more development, to build the resilience that they will need to cope with the inevitable impacts of climate change. “More population will not only mean that more people will have to deal with these impacts; it also means that the meager resources will have to be shared between more people and that each poor person will have less to build their resilience on.”

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“If you ask me who I am, I will say I am a storyteller” – Reza Aslan

Interview with Dr Reza Aslan

“If you ask me who I am, I will say I am a storyteller”

Dr Reza Aslan’s journey has been long and winding. From a young Shia Muslim migrant from Iran to USA, to a converted Christian at the age of 15, to again a Muslim a few years later, Aslan’s journey is the quintessential journey of discovering one’s self and one’s religion. Perhaps this is why he resonates with his audiences and readers. Faith, however, has remained a constant with him. Answering a question from the audience at a packed auditorium at Habib University Karachi where he delivered a Yohsin Lecture on the topic ‘Why Do We Believe’ on June 13, Aslan distinguished between faith and religion with the help of a metaphor. According to him, when we dig wells, the wells may be different but the water under the earth’s surface is all the same. Similarly, the water is faith and the wells are religions — they are all the different paths to faith, he says.

In this exclusive interview for The News on Sunday, Aslan begins by talking about how he gets away with presenting opposing and often offbeat points of view. “When you are talking about issues of religion and politics, you are talking about things that are very deeply embedded into people’s identities, and sometimes will react if they feel their identity is under attack. My relative success has been predicated on having respect for people who disagree with me, and taking faith and religion seriously even when I disagree with it. Recognising that my arguments are always going to be founded upon reason and history and fact has, for the most part, inoculated me a little bit, but I still get into trouble all the time, both personally and professionally.”

As a person of faith, and one with a keen and critical eye on world history and politics, Aslan’s take on the role of religion in public life is unique. “I always make a clear distinction between Secularism and Secularisation,” he says, further explaining the two concepts. “Secularism is a political ideology that says religion should have no place in public life. I understand where that argument comes from but it doesn’t make any sense in a modern constitutional democracy if the entire point of a democratic system is to allow people to find representatives who share their values, their ideas, and their worldview. Religion becomes a very easy shorthand for those complicated notions. So it’s ridiculous to say that religion should have no role in politics and in the public realm. Of course it should.”

Pakistan has an extraordinarily unique history. “This country defined itself from the very beginning in terms that are impossible to actually live out. When you call yourself an Islamic state, you need to figure out what that exactly means.”

He goes on to add that Secularisation is about making sure that religion doesn’t have political authority, and that religious institutions are distinct from the governing bodies and the political authorities — that authority itself over the state should rest not in the hands of religious leaders but in the hands of political leaders. “Secularisation is very important when it comes to modern constitutional state because, particularly in countries where vast majorities share a single religious tradition, religion can very easily become authoritarian where those who disagree with the religion, those who have no religion and those who have a different religion become second class citizens. That is not a democracy.

“That’s what I think is important. Secularism is not the key to a functioning democratic state. Secularisation is the key to that, because Secularisation is about pluralism, about rights of all citizens regardless of their religion,” he says. In Aslan’s opinion, Secularism is based on the forceful removal of religion from the public realm which is anti-democratic. “It’s anti-democratic when France does it. It’s anti-democratic when Turkey used to do it. It’s anti-democratic when Egypt does it.”

Commenting on Pakistan’s historical journey and the role of religion in it, Aslan says that it is important to recognise that Pakistan has an extraordinarily unique history. “This country defined itself from the very beginning in terms that are impossible to actually live out. When you call yourself an Islamic state, you need to figure out what that exactly means. Does that mean it’s a state for a majority Muslim population or does it mean that it’s a state founded upon Islamic ideology or does it mean that it’s a state that is run according to Islam? I think the problem is that it was never explicitly defined; it becomes difficult to have these kinds of ideological conversations about the nature of the state when you have no choice but to build the state. That of course had to do with the fact that it was created in the midst of the single largest mass migration in human history to this day.”

According to him, that more than anything explains the tumultuous history of Pakistan going from a secular democracy to a military dictatorship to being a religious-inspired state, then back to being a secular democracy and then a military dictatorship and then a religious-inspired state. “What the experience of Pakistan shows — and that is precisely why it is so unique — is the difficulty of trying to define a nation state in religious terms,” he says, mentioning Israel as a cautionary tale, “a country that is disintegrating from within”.

Fiercely and openly critical of Modi, Netanyahu, and Trump, Aslan says that it has been a very long time that Pakistan has had a Modi or a Trump. “We cannot say that there can never be the rise of a demagogue in Pakistan. But for the most part, I think the (political) trends are moving in a positive direction,” he says. Commenting further on the kind of political leadership he is wary of, he says that a global-wide identity crisis has created the vacuum for authoritarian demagogues to step in and provide an easy way for citizens of these states to define themselves according to religion or race or ethnicity etc.

“There’s nothing about India or about Hinduism that explains Modi, for example. What is happening in India and Israel and USA is a global phenomenon; it is not just about these individual countries.”

To Aslan, while religion is a potential tool for social stability, and collective identity, he feels that like any tool, it can be wielded in positive and negative ways. “It’s all about the person wielding it. I cannot say religion is a force for good or force for evil, or that it causes peace or causes violence. Religion doesn’t do any of those things. People do those things. Religion is a means for them to achieve those ends.”

When asked what he enjoys most — teaching, public speaking or writing books, his answer is simple. “It’s all storytelling. Stories are how we define ourselves and communicate our ideas to the world. The platform doesn’t matter. If you ask me who I am, I will say I am a storyteller.”

http://tns.thenews.com.pk/ask-will-say-storyteller/#.XRMmmugzbIU

Different strokes for different rozaydaars

Times have changed and so have the food choices of those observing the fast

Different strokes for different rozaydaars

The idea, back then, was that you need to stuff yourself with such food at sehri that will help you not feel hungry, nor thirsty till Iftar. While that never actually happened, nutritious and filling foods like khajlapheni, and qeema  or aloo parathas kept one full enough at least till mid-day. And then we topped it off with jugs of water, and lay there on a couch later, panting with over-eating, filling up our bellies in the hope that the holy month would suddenly give us the capacity of a camel to store food and fluids.

That was the era where we didn’t care about good cholesterol or bad cholesterol, and it didn’t really matter if, instead of losing weight, Ramzan meant gaining a few pounds. Ramzan is about self-control, starting with food. It actually has been interpreted by a foodie nation as being just the opposite — about indulgence in food. But with awareness about healthier food choices, all of this may have begun to change, at least in urban Pakistan.

One thing is for sure: the health-conscious fasting person now focuses more on sehri than on iftar, particularly, if the said person also wants to pray peacefully at night, at home or at the masjid. For such people, they have a completely altered routine in Ramzan. Heavy, oily food, and an overload of beans and chickpeas can cause bloating and digestive issues, even though the latter two are very good sources of nutrition and should be taken in moderation.

The one change that we see is that unlike earlier when people used to first have iftar, then dinner a few hours later, and then sehri, the more conscientious eater is eating just two meals a day, with in-between healthy snacking if needed.

For many of us, the parathas and khajlas made of white flour and laden with fats have been replaced by porridge, oatmeal, brown bread, chapatis made of whole-wheat flour, and even brown rice. However, some things still remain indispensable for sehri, like eggs. Eggs have earned that spot as a favourite for good reason. Eggs provide 13 essential vitamins and minerals (vitamin D, riboflavin, selenium), antioxidants Lutein and zeaxanthin, and high-quality protein, all needed for one who is fasting.

The new entrants are the health-benefit items that once were seen as medicinal, but are now seen as “snacks”.

Dates, traditionally seen as the thing to open one’s fast with, have now made their way to the sehri meal as well. They are not just high in antioxidants, fiber, and potassium, but also provide essential nutrients, such as vitamin B-6 and iron. Bananas, an essential component of the fruit chaat, is now being eaten by the health-conscious rozaydaar as part of the morning pre-fast meal as well, as they provide fiber, potassium, vitamin B6, vitamin C, and various antioxidants and phytonutrients.

One of the things a person fasting in summers goes through is possible dehydration, or an electrolyte imbalance. Bananas, known as the leader among fruits and vegetables containing potassium, help control muscles and blood pressure. Thus bananas replenish electrolytes.

While restaurants offer attractive deals, the regular and more cautious people who observe fasting are being seen avoiding the eating out experience. “Unless it is unavoidable, me and my family have stopped eating out to eat at iftar,” says a regular fast-keeper. “The food in restaurants, no matter how tasty, will be always more oily, more rich in spices, and probably less hygienically prepared compared to home-cooked food.”

“When the fast is broken after almost 15 hours, it takes the body time to adjust to eating and drinking. It’s not a good idea to suddenly overload your system after a break from eating for a long time. The food’s not going anywhere! Why not have it in breaks, going gentle on your system?”

Also read: Oh, this makes sense

The new entrants are the health-benefit items that once were seen as medicinal items, but are now seen as “snacks”. You might see a particularly health-aware friend munching on iceberg lettuce with pine nuts topped with chia seeds as a post-iftar snack. Another relative might be having a combo of flaxseed, pumpkin seeds, and prunes with yogurt at sehri. And yet another one might be seen sprinkling moringa leaves powder on top of a sugar-free fruit chaat.

Different strokes for different rozaydaars.

Yes, times have changed and so have the food choices of those observing fast. Many of these changes are positive. Perhaps people have begun to realise that Ramzan and fasting do not remind us of stuffing our mouths with food on tables laden with 20 items, but in fact this month is a reminder of the joys of simple, wholesome, healthy food that is a blessing from the Creator. Abundance is, then, perhaps, in our attitude towards food, not in the quantity. It is the month of gratitude. Good health calls for gratitude, and practical gratitude demands taking care of your health.

Happy fasting and healthy feasting.

http://tns.thenews.com.pk/different-strokes-different-rozaydaars/#.XRMjE-gzbIU