What does an 11 year old go through when one fine day, she starts bleeding in school, and she was never forewarned by her mother about menstruation? In a highly guarded and conservative setup, what does a 16 year old girl go through on the night she gets married, if she was not told even the basics? Imagine the regret of a 27 year old man who, after marriage, finds out that his reckless sexual adventures and lack of awareness about safe sex have left not just him but his unassuming wife carriers of HIV.
These are common scenarios. Time and again, incidents such as these make us realize that Reproductive Health Education is necessary. But it is an issue that remains controversial.
In a society where a girl going and buying sanitary napkins for herself or a boy asking his father about the changes he notices in himself as he comes of age might be deemed inappropriate, cultural norms make this a sensitive topic. The rampant upsurge of Sexually Transmitted Infections (STIs), Pakistan being a low-prevalence high-risk country when it comes to HIV, and commonly known incidences of sexual harassment and rape: these factors make it important for young adults know details to protect themselves against potential dangers. The question then remains how.
Dr Azra Ahsan of NCMNH (National Council for Maternal and Neonatal Health) is clear that we DO need to educate adolescents about it, and feels that the bigger question is how. “To begin with, the term ‘sex education’ should be replaced by the term ‘reproductive health education’. Using acceptable terminology, talking in a non-controversial way and using the right approach is very important,” says Ahsan. She feels it is a necessity. “It is about growing up. It is about how to deal with the changes in your body both physically and emotionally.” In Ahsan’s opinion, prominent people of society who have an impact on people as well as religious leadership should step forth and talk about it. “I have seen morning shows in Saudi Arabia that talk about these issues in a very candid manner. Why can’t we?”
It is rare that young adults are taught these facts of life by parents. It is usually a cousin, a friend or someone who is equally clueless. We may argue that children today know everything they need to through the internet, but what percentage of the children in Pakistan have access to the internet? Moreover, how reliable are the sources of information on the internet, and how equipped are young adults to discern among this plethora of information and figure out which information is accurate or not?
Iqra Amin, 17, feels that “Children in cities are much more aware. Our Biology course in O levels includes all this. It is the children and teenagers my age in rural areas and from under-privileged backgrounds I worry about. Their sources of information should be better. Parents need to step up their game and firstly get more well-informed themselves and then talk it over with their children for their safety.”
When asked whether this should be taught in school or not, Faisal Naveed, 17, has a different reason for why he thinks it should not. “In school when this subject is approached in class, it becomes a laughing matter. Cheesy jokes follow and no one takes this important matter seriously. Also, when society talks about these issues openly, it may become more acceptable to indulge in reckless sexual behaviour,” says Naveed.
For the same reason, parents and many people resist the idea of teaching sex-ed in schools. Earlier in 2009, a controversy arose when Dawood Public School for Girls, Karachi, introduced reproductive health education in a science text book which was included in its curriculum. The parents protested vehemently. “The reproduction process is something natural and children should learn it,” argued the school’s administration in face of criticism.
This incident elicited different responses. Sindh Assembly member Humera Alwani is on record supporting reproductive health education, saying “We cannot leave our children in darkness anymore.” But commenting on the incident, Naveed Zuberi, adviser to Education Minister Pir Mazhar-ul-Haq, had said that they would not allow any school to teach such courses, saying: “This is not USA or Europe, this is Pakistan and our culture does not allow us to teach these things at school”.
But experts feel that discussing in class might actually be a good idea, under guidance of a teacher or counselor, as all the students are the same age bracket and are going through the same. Therefore it makes it easier for them to digest the often tricky subjects.
Dr Badr Dhanani, dermatologist, has studied in-depth about the spread of HIV and STIs in Pakistan. He supports the idea of teaching reproductive health in schools. “The increased usage of the internet has opened avenues for mis-information.and pop up ads create sexual curiosity. Thus, in the absence of sound knowledge about sex, curious adolescents commit mistakes. Teaching children about sex in classroom would encourage them to view it as a natural, normal and healthy part of life. If youngsters learn about sex in a scientific and objective way, they would be more careful before indulging in sex secretly,” says Dhanani.
Tackling the concern that openly talking about these issues may increase promiscuity, Dhanani feels that “although we profess an orthodox society, the ground reality is different.” Thus, we assume an ostrich-like attitude and pretend these things do not happen.
Saima Rauf, an artist and a mother of two teenagers is of the opinion that “In a society that is largely not literate or aware, health workers can play an important role in increasing awareness.”
Often, people assume the umbrella term “sex education” to include limited topics. However it includes not only the basics about the male and female reproductive system, but also topics like menstruation, the physical and emotional changes of adolescence, the growing up process, sexuality, Sexually Transmitted Infections (STIs) and the avoidance of acquiring these infectious diseases by means of safe sex and use of condoms. Taboo subjects like masturbation are also touched upon.
“Child abuse (sexual) is increasing. Sex education can supply our young people the tools to report and resist abusive behaviors, and provide them with a forum for expressing their fears openly. This will help forestall it,” believes Dr Dhanani.
Awareness about the sexual process, pregnancy, and contraception helps young people avoid getting into unwanted situations.
In 2011, Psychiatrist Dr Mobin Akhtar’s book that equated sex education with the Islamic perspective, using Quranic verses and ahadith for evidential support, was criticized. But Dr Akhtar stayed firm on his opinion that not informing young people about these issues can leave negative psychological impacts and in fact hinder them from practicing Islam correctly. His book quotes examples of how the Prophet Muhammad (pbuh) was open to answering questions pertaining to what Islam permits and what it doesn’t when it comes to sexuality.
The question, then, we can safely assume has somewhat changed. More than whether we need to give adolescents this vital information or not, the question remains how. And this has to be done softly but surely, bearing religious and cultural sensitivities of people in mind.
An edited version of this article was published in “The News on Sunday”: