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Monthly Archives: November 2017

Truck art for education

An initiative that spreads pro-girls’ education slogans via truck art is hoping to change mindsets in Kohistan and around the country

Truck art for education

“It’s an initiative that I am so proud of because the local community has owned it,” says documentary filmmaker and rights activist Samar Minallah who developed the concept of a culturally relevant advocacy initiative through truck art. “The brightly painted trucks are like moving billboards that amplify a message from one part of Pakistan to another. My visit to Kohistan further reinforced my belief in using art and traditional motifs and designs for raising awareness,” says Minallah. Kohistan, according to the Alif Ailaan Pakistan Education District ranking 2015, is the worst performing district educationally in KP.

According to local teachers, children of primary schools of Pattan look forward to attending their newly painted classrooms decorated with bright indigenous symbols from Kohistan.

Using indigenous sensitivities and art in mind, Minallah interviewed local people for their opinion and collected local embroidery motifs created by village women as the preparatory research for the project, to incorporate in the final drawings and paintings. “The aim was to not only raise awareness about the importance of education for girls but also to honour local art and crafts, and develop a sense of ownership for the local community members,” she says. The total number of trucks that have been painted till now with these messages is 30.

“The feedback has been great because indigenous art and tools were used to convince local communities about the importance of education for girls, so it found acceptance and appreciation,” said Dr Ziaur Rehman Faruqi who is Head of Programmes at National Integrated Development Association (NIDA), and is actively involved with the project ‘Girls Right to Education’ in collaboration with UNESCO and both the federal and provincial governments. In the spirit of collaborative efforts, Faruqi shared that they have brought on board not just local leaders and parents but also the religious clergy and the political leadership for what he called a “holistic approach”. “This could not have been achieved otherwise as Kohistan had multiple issues like ghost schools and teachers.”

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School children of Kohistan took part in interactive painting activities .

According to local teachers, children of primary schools of Pattan look forward to attending their newly painted classrooms decorated with bright indigenous symbols from Kohistan, shares Minallah, adding that truck owners from Punjab have reached out to the artists to have their trucks painted with similar images and messages. “One of the local mosque imams asked if his mosque’s name could also be added on the newly painted bridge along with the pro-education empowering messages,” she says. Local people take selfies and photos from their mobile phones in front of these bridges of Sholgara, Dubair and Bisham adorned with important messages such as

Bhai aur behen mil kar school jaain, Zindagi main ilm se roshni jalaain (Both brother and sister should go to school and bring to life the light of knowledge) and Apni aulaad ko taleem ka tohfa daen (Give your children the gift of education).

Atif Khan, Minister for Education, KP, shares how education of girls is now being seen as a priority. “We are especially working on education for girls. Examples are that 70 per cent of all new schools we are working on are schools for girls, and also 70 per cent of the work to provide missing facilities in schools is focused on facilities for girls,” he says. As an incentive, female education managers in backward districts like Kohistan are being paid 50 per cent extra. Lauding the initiative to sensitize communities towards the right of education for girls through truck art, the minister said that traditions don’t change overnight. “Just constructing schools and passing bills is not enough. It is the mindsets that have to be worked on.”

“Work on this project has made me happy. It made the girls and their teachers happy. The classrooms looked beautiful. The girls would join in painting with me,” said Shaukat Khan, the painter who has till now painted these positive messages with colourful drawings on three bridges and eight classrooms in far-flung parts of Kohistan. “Initially the locals resisted. They were even upset. But once they saw the finished work, they began to like the idea. Change is starting to happen,” said Khan. Khan, a father of four daughters and one son, is an artist from Swat, who has made sure his daughters are going to school “because girls must get an education”.

http://tns.thenews.com.pk/truck-art-education/#.Wh–5UqWbIU

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Old age matters – What being a caregiver to my mother & her passing taught me

Caring for the elderly is not just an act of love. It is a skill that one acquires over time, whether you are family or a paid caregiver. It is an upward learning curve, and the only way out is through

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Two months ago, I lost my mother after her ten years’ long battle with the debilitating and progressive disease called dementia. On that first night after she passed, I got a message from a friend saying, “As you settle down to spend the first night without her in this world….” These words struck a chord with me. As people poured in to condole, and said, “you must have been prepared,” I honestly didn’t know if I was actually prepared, even though I knew it was inevitable. You’re never really prepared for the emptiness the loss of a loved one leaves. Yet, awareness helps us deal with this testing time.

For those who can afford to hire help or get their elderly loved one treated by trained healthcare practitioners, the blow is relatively cushioned, and the biggest struggle is the emotional pain one goes through to witness them fading away. This is when you learn the word ‘palliative’ care. “Sadly, less than 1 per cent Pakistanis have access to specialty palliative care,” says Dr Atif Waqar, Geriatrician and Section Head for palliative Care at the Aga Khan University Hospital, Karachi.

Geriatrics and Palliative care, as he explains, are two different sub-sections of medical care. “Geriatrics is care and treatment of the elderly, while palliative care is aimed at relief and prevention of suffering for both the patients as well as their families. Palliative care is not necessarily end of life care; that is a common misconception that sometimes even healthcare providers have,” he explains. Palliative care, then, is a more holistic approach. “It is actually all about living, not death. However, if all treatment options have been tried and exhausted, then palliative care does involve end of life or hospice care.

“Geriatrics is care and treatment of the elderly while Palliative care is aimed at relief and prevention of suffering for both the patients as well as their families. Palliative care is not necessarily end of life care; that is a common misconception that sometimes even healthcare providers have,” says Dr Atif Waqar.

Thus, we can say that all end-of-life care does come under palliative care but all palliative care is not end of life care.” Palliative care is a shift in focus where medical practitioners try to palliate the symptoms. Studies show that terminally ill patients actually live longer with holistic palliative care rather than with aggressive treatment.

As a son and caregiver, Afaq Ahmed, who lost his mother a few years earlier and his father just six weeks ago, has had to make some tough choices along with his siblings. He describes the painful experience of seeing his father, who loved to eat, refusing to eat due to dementia. “He would purse his lips tightly, and even if we managed to put something in his mouth, he kept the food in for a long time,” he says. The disease progressed, and he shares that it was a very tough decision when they decided that they wouldn’t use [aggressive] means to prolong his agony.

“Doctors and physicians are trained to save lives, which is why sometimes they use invasive means to keep the patient alive, but end up prolonging their suffering,” says Dr Waqar, and shares the questions that palliative care doctors put in front of the patients’ families. “Questions like ‘What would your loved one have wanted? Would they have wanted to live with this quality of life in a state of complete dependency? Would they have liked to be on a ventilator or someone pumping on their chest for CPR when it’s of no benefit? Would they rather choose to pass with dignity?’” What is often seen as defeat, then, by caregivers or physicians, is actually an informed choice.

“Doctors told us to consider if this is the kind of life our father would have wanted. My parents repeatedly used to say that they would not want a life of dependency and they were ready for the transition. We based our decision on the honest answer to that,” says Ahmed. He and his siblings decided to not force feed their father, neither by mouth nor through means such as a nasogastric (NG) tube.

Read also: Care for the caregivers

However this does not imply that all medications and treatment is discontinued. According to Waqar, intravenous fluids and antibiotics are actually therapeutic and if they help alleviate symptoms they should be continued till the end. Pain relieving medicines, like Morphine, are an option at this stage.

“Morphine is on WHO’s List of Essential Medicines that should be available because it is everyone’s right to be relieved of pain. But in Pakistan limited hospitals are given very specific and limited quotas. We strongly urge the concerned drug regulatory and health authorities to make it available to trained medical practitioners,” says Dr Waqar.

Ahmed and the family did use last resort pain relieving medications to ease his father’s pain in the last few days. “These medicines are not easily available but you can get them through the hospital or doctor under whose treatment your loved one is.”

It is not, however, easy to predict when it is time to let go. “Prognostication, or an estimation of survival, varies from illness to illness. It is both a science and an art. The variables differ from person to person. Doctors run tests to determine the actual situation,” says Dr Waqar. In his opinion, estimation is much easier in terminal stage cancer, for example, but not so easy in neurodegenerative diseases like dementia.

“Sometimes end stage patients surprise you and bounce back. There are dips, plateaus and peaks in their condition. However, when we see a steady decline in these four areas — functional, clinical, nutritional and cognitive — we know that the patient is approaching the end.” You see your loved one becoming increasingly dependent for even small chores, from being on the wheelchair to being bed-bound, and sleeping most of the day.

“They eventually stop eating; it starts with a decrease in taking solids but goes onto difficulty in even swallowing liquids. This is a natural process towards ‘transition’ which we commonly know as death. When the organs begin to shut down, the caloric requirement becomes lesser and lesser,” explains the doctor, adding that the family often thinks they are starving, which actually they are not; they no longer need that much nutrition. Caregivers attempt to force feed them which does more harm than good as the food ends up going in the lungs and aspiration pneumonia can develop.

In a lot of cases, the patient suddenly begins to show improvement or a burst of energy in the last few weeks or months. “That is actually the calm before the storm. This burst of energy helps them finish unfinished business. These facts are scientifically proven and are not hocus pocus,” Dr Waqar says. In his opinion, people in their end stage have very strong awareness about the upcoming transition. Patients are known to experience visitations of their loved ones who have already passed on and are now beckoning them. Near Death Awareness (NDA) is part of the dying process but caregivers often confuse it with delirium. Some patients who can articulate their experiences communicate what they are going through; others, like patients of advanced dementia, may not be able to.

The role of the caregivers, whether they are family members or paid staff, is one that is both painstaking and rewarding. Zaiba Emanuelle, a certified nurse in Karachi, works with elderly patients and has seen a surge in the number of nurses being employed in homes for the elderly. In her experience, patients are easier to handle compared to families of the patients. “The family keeps interrogating us. I understand that they have to do it, but it’s not easy dealing with them,” says Zaiba. “I have learnt that to deal with elderly patients, you have to understand them, and treat them with as much gentleness as one would treat children. It’s all about patience and flexibility.”

As a caregiver, I have learnt tremendously about life and death because of this sojourn on the path of dementia with my mother. I have learnt about what it means to be an elderly person in the twilight years of life, or to be a caregiver. Caring for the elderly is not just an act of love. It is a skill that one acquires over time, whether you are family or a paid caregiver. It is an upward learning curve, and the only way out is through.

When senior citizens are not a priority

Expecting specialised geriatric care might be too ambitious for the average Pakistani who sometimes does not even have a comfortable home or a devoted caregiver. “The numbers of neglected and abandoned senior citizens have escalated, and the reasons are many,” says Faisal Edhi of the Edhi Foundation that has been taking care of abandoned and underprivileged elderly since inception.

He feels that the dismantling of the joint family system, urbanisation, the thrust on industries, and the increase in population — all this has left families with little time to care for their elderly. “The government needs to face this reality and think of setting up old-age homes in peri-urban areas and outskirts of cities; this would be a much more economical option compared to hospitals. But senior citizens are not the priority in an already failing service sector,” he says.

In 2014, both Khyber-Pakhtunkhwa (KP) and Sindh provincial assemblies came up with laws guarding interests of the elderly. The laws are ambitious. Sindh Senior Citizen Welfare Act, 2014, aims at lodging establishments, free geriatric and medical services, 25 per cent concession in all private medical centres and 25 per cent discount on purchase of essential commodities to name a few. However, what is missing is the implementation. Quality care for the elderly requires a steady stream of money, something not many Pakistani families can afford.

http://tns.thenews.com.pk/old-age-matters/#.Wh–3kqWbIU

Fresh thrust on social sciences and liberal arts

Academics question quality of education and lack of level-playing field for the youth of Pakistan, laying emphasis on the importance of fostering a sensibility for social justice at a conference at Habib University

Fresh thrust on social sciences and liberal arts
Closed doors of narratives that open only for a select few, and educational disciplines that act as isolated bubbles — that is the academia we mostly see. But in a postcolonial world, Pakistan is seeing a fresh thrust on social sciences and the emergence of liberal arts educational institutes. When scholars open their doors to the public and invite them to engage in conversations that problematise and aim to solve issues, you know that there is progress.

Talking of Pakistan’s struggle with education at the core of development, postcolonial higher education is an often ignored part of it. “One of the major demerits of postcolonial education has been that ‘education’ has almost exclusively meant ‘technical education’. In contrast, pre-modern forms of knowledge were very sensitive to the fact that knowledge was an end in itself rather than a means to something else,” said Dr Shahram Azhar, Assistant Professor, Social Development and Policy at the Habib University (HU), Karachi. Recently, HU held its third ‘Postcolonial Higher Education Conference’ highlighting the specific historical and educational challenges of the postcolonial world, under the theme ‘The Inheritance of Injustice’.

The educational system replicates and reproduces the inequality that exists in society, and this is completely unacceptable. A country that does not provide opportunities to its weakest members of society cannot prosper.

Sharing his views with TNS, Azhar added that resultantly, we have ended up with people with a lot of technical expertise but the inability to creatively apply those techniques to our unique social and economic conditions. “We’ve essentially been trying to copy and paste Western models of knowledge and thinking. What we have inherited is a colonial way of reasoning about the world; colonial education was precisely the production of knowledge for colonised subjects, rather than citizens.” In a world where the aim of learning is earning, Azhar’s words ring true.

In a divided and polarised Pakistan, liberal arts and a better thought out system of education can play a positive role. “The place where Pakistan finds itself today is rife with ethnic and class bias, gender disparity and religious bigotry. People often blame this on lack of political leadership but one of the reasons for this intolerant attitude and lack of civic responsibility is our failing education system. From the earlier dictatorial times when state funding would be diverted towards the sciences and very little towards social sciences, it has set in an attitude towards education as a means to an end instead of an end in itself,” said Dr Sabyn Javeri, award winning writer and faculty member at the HU, who was part of a panel at the conference. Her paper was on “Teaching Feminist Fiction in the Pakistani Undergrad Classroom.”

Speaking to TNS, Javeri said that one of the things that a Liberal Arts education does is that it provides you wholesome, all-rounder access to learning. “It is interdisciplinary, a mix of science and humanities. It promotes broad-mindedness, tolerance and pluralism, which is very necessary in a country as diverse as ours. This singular approach to studying where science students are not exposed to literature or even the fact that reading out the text book is not encouraged, is promoting a dangerous, extremist mindset.” She said that encouraging students to question was a core advantage of this system.

Azhar’s views echo the same thought. “A liberal arts education, like that at the HU, strives to change the irrational way of looking at education by incorporating a sensibility for social justice, equality, egalitarianism, peace, and tolerance in students so that they can creatively apply the technical knowledge that they acquire to improve the lives of others around them.”

However, unless the academia and scholarship play their part, achieving the goals Azhar mentioned, seem impossible. In his opinion, while academic scholarship can play a central role in fostering pluralism, it would depend, in turn, on the degree to which it can foster a sensibility for social justice. “This must happen at multiple levels: at the level of producing new research and knowledge, at the level of designing curricula that transfer that knowledge to students, and at the level of how that knowledge is transmitted to students. We have to develop sensitivity to diversity; religious, cultural, political, linguistic, gender, class — within our education systems and this must happen at all levels of the process of producing and disseminating knowledge,” said Azhar.

However, reality remains that while such an educational system is the ideal, few have access to it. Azhar candidly termed the current level of inequality in Pakistan’s social system ‘vulgar’.

“The educational system replicates and reproduces the inequality that exists in society, and this is completely unacceptable. A country that does not provide opportunities to its weakest members of society cannot prosper,” Azhar said. She finds this very disturbing. “On one hand we have world class universities like the IBA, LUMS and HU, but how many people have access to them? With the level of state education, only pupils hailing from a certain class, pass the stringent tests of these prestigious institutes. Yes, there are scholarships and equal opportunity policies, but how many from under-privileged backgrounds have the awareness to make use of these policies. And even within class, there is gender bias.” A conference like this one really helps, she said, adding, “People are thinking about it and that’s always a good sign.”

Talking of solution to this jarring disparity, Azhar mentioned multiple solutions that require a multi-pronged approach. “First, it calls for active participation of the well-to-do sections of society. They need to step up and create other charitable institutions that make it possible for members from marginalised socio-economic backgrounds to access higher education.

“Secondly, we need more state support. Ultimately, a model like the HU can only be replicated at a higher level via state support as there are limits to what private institutions can do,” he said.

As a third tier of the solution, he mentioned the need to democratise education and educational institutions. Students, then, must be made to participate in the process of deciding what they study, the policies that govern their lives, and how those policies should be executed. “We cannot have a democratic society if schools, colleges, and universities are undemocratic.”

 

Farahnaz Zahidi

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The writer is a freelance journalist with a focus on human rights, gender and peace-building. She works in the field of Corporate Communications.