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A packed December – When Non-Resident Pakistanis Flock to Pakistan

A month of homecoming, packed with weddings and socialising, can be overwhelming for the visitors and the hosts

A packed December

Pakistan is living with a big hole in its heart. That hole in its heart is Pakistanis who have left for greener or richer pastures, grazing in the economically lucrative lands in Europe, USA, the Middle East, or even down under. With each person who leaves, this hole widens. Rarely do you come across a Pakistani family that is still “whole’. At the hands of this exodus, we have missed out on our best.

Fragmented families suffice with Whatsapp calls and Facetime connections. Most of our friends of school and college are somewhere far away. Every other home has children who have left for better education and exposure, with parents very aware that once they go, they might make new homes in faraway lands. Yet we are making these choices, every day, seeing this migration as the chance at better lives and better futures.

Yes, Pakistan is indeed living with a big hole in its heart.

But come December and that hole starts to fill up — unnaturally and temporarily.

Birds, mammals, fish — the animal kingdom is full of examples of seasonal migrations. Humans have a history of doing it too — for agricultural harvesting, for grazing their cattle, for finding summer or winter jobs.

But what is happening in urban Pakistan is unprecedented. December is the month that non-resident Pakistanis choose collectively to visit their birthland. This includes our children who are studying in universities abroad or offspring who are working abroad — they get their winter break in December. While this should mean a time for families spending time together and re-bonding, it often does not end up being so, as social commitments seem to multiply by a hundred, if not a thousand, in December.

On an average December weekend, people are invited to anywhere between two to four weddings a day. With weddings come preceding or subsequent shopping sprees. The fact that Pakistanis who are now used to cooler climates request that relatives in Pakistan keep weddings in winters, and want to visit a city like Karachi not when it is 40 degrees Celsius but a milder 15 degrees is understandable. And so it is.

Overcrowded shopping malls and eateries, breakfasts, brunches, lunches and dinners. Traffic on the streets. Late nights. On the peripheries there are the day trips to beaches, farmhouses, or even the occasional trip to a village or a smaller town, because we love to romanticise villages, poverty, and the ‘colourful culture of small towns’. Even Karachi’s infamous viral fevers, cough and flu cannot deter the incomers nor their hosts.

What does this mean for us the resident Pakistanis? Put in simple words, we have to put our lives on hold. While we continue going to work or running everyday errands, we have to accommodate a lot more and wish that each day was not 24 but 48 hours.

As Pakistanis, our most important and unavoidable way of showing affection is feeding people. The stomachs of our guests from abroad go into culture shocks as instead of soups, salads, sandwiches, less spicy and less oily food, they are offered nothing less than nihari, qorma and katakat, dripping in oil and followed by halwas in desi ghee. No amount of antibiotics they may have taken in precaution helps. It is tough on the tummies, but saying no is difficult to the overzealous resident Pakistanis. But it is not really anyone’s fault. This is our way, as a nation, that we show love and care — we feed people. Also, if we don’t offer a meal or go to meet our guests, it will be said “yeh log buhut badal gaye hain” (they have changed).

There are, you see, dynamics of Pakistanis who live abroad. If they left Pakistan 30 years ago, they have an image of Pakistan frozen in time. Their relatives who were young teenagers listening to George Michael and Madonna when they left are now gray-haired and popping blood thinners into their system, parenting children who are millenials. Of course Pakistan has changed, and yes the people have changed, because societies are fluid and not static. But there is an unsaid pressure on those still living in Pakistan to pretend that we are still the same.

It is also not easy for those visiting Pakistan. Too many people to visit, to meet, to give gifts, to stay connected with. Too many obligations. And at times, if not always, the pressure to pretend that they are still connected to these people in terms of culture, whereas the reality is that exposure and life experiences change us. We evolve.

While this December influx of people means an air of festivity and excitement, more money coming into Pakistani economy, and lots of feasting and meeting-up, it can be overwhelming for both the visitors and the hosts. Why not have weddings in March or September? Or visits to Pakistan in February or October? Too much of a good thing dilutes the effect. Let’s space it out, shall we?

PS: Relatives, siblings and friends visiting Pakistan in December, please don’t write me off after reading this, and believe me when I say I love you all visiting. Promise.

http://tns.thenews.com.pk/packed-december/#.XDxJpbhS81k

No time to sensationalise – How Media Reports Suicide

The journalists reporting on suicide in Pakistan are not really trained to do so. They are learning as they go along by trial and error

No time to sensationalise

Death induced by suicide is a life cut short by self-directed violence. It finds its way in the newspapers and news TV channel segments readily. Often mediapersons reporting it do not know what an important part of the equation they are: With every suicide, there is an unfortunate but important duty laid on the shoulders of the mediaperson working on that news story. Will this opportunity be used to raise awareness, and perhaps help save lives from a similar fate? Or will it be just another sensationalised bit of news?

The choice is ours. We, the journalists, have important work to do in society as relayers of information. This must be done carefully, consciously, and sincerely.

But when it comes to mental health issues, particularly suicide, is it really the fault of the journalist, when he or she has never been trained in the subject?

Journalists have “beats” to report on; health is an important beat — public health, sexual and reproductive health, maternal and child health, and other sub-specialties under the health beat.

However, there has been no formal training of Pakistani journalists to date on how to have mental health as a beat, and how to report on it. If a journalist has organically acquired a certain sensitivity to report on delicate issues, then he or she will apply it when reporting on suicide as well. Yet journalists may often get lost in the quagmire of details when reporting on a suicide. Details like the where, when and how. The opportunity of raising awareness on the issue is often lost in such reporting.

This year in June, fashion designer Kate Spade and celebrity chef Anthony Bourdain died by suicide just days apart. There have been relatively well known Pakistanis who died after committing suicide. This has shed media light on the subject. A study on ‘Newspaper Coverage of Suicide‘ done at Sindh University by Mahesar RA states that “One person, after every 16 minutes, dies not merely because of accident or any other disease but intentionally because of suicide [sic]”.

However, the journalists reporting on it in Pakistan are not really trained to do so. They are learning as they go along by trial and error. The subject of “suicide” — and mental health on the macro level — is staring at us in the face as an unavoidable news beat. But the lack of training leaves means we are making mistakes.

Reporting on suicide, and mental health issues, is a huge responsibility, as well as an opportunity to make a difference. These are not stories to be sensationalised. These are not lifestyle or entertainment stories.

One of the most common mistakes is extreme positions taken by the media when reporting on suicide. One extreme is stigmatising and re-stigmatising both the person who committed suicide as well as the family. The sad music while reporting on suicide on tv, the hackneyed jargon, the nuanced but audible judgment in the news report — it all shows a lack of objectivity.

However, the other dangerous extreme is romanticising the act of suicide — of glorifying it, and instead of presenting facts about this act of extreme self-directed violence, perpetuating myths about it and calling it a “choice.” With the suicides of the aforementioned celebrities (Spade and Bourdain) experts began talking about the risk of triggering what is called the “Suicide Contagion.”

Experts of mental health affirm that suicide (of one or multiple well-known people), can lead to an increase in suicidal behaviour among people who are already at a risk of it. Thus, it is important that these news reports do not just mull over details and allude to it as a heroic act, but present the fact, which is that suicide is, in a majority of cases, linked to mental health issues.

Suicide almost always is not something that happens suddenly out of the blue. It has been considered by the person earlier. There may have been warning signs which people close to the person may have missed. An article published by International Journalists Network titled, Guidelines for Reporting about Suicide, aptly suggests to journalists that they must not suggest that a suicide was caused by a single event. “Suicide is complex, and is often the outcome of different causes, including mental illness — whether recognised and treated or not,” says the article.

Giving details of the method employed for the suicide may also contribute to the suicide contagion. Graphic details and photographs are not only disrespectful and insensitive to the deceased and the bereaved family, but also end up giving ideas to those who may be thinking on the same lines.

Care must be exercised even when writing an obituary for the person who left this world — whether as a journalist on a news platform or as a friend or peer on the many social media platforms. Be careful of the language you use. And most importantly, focus objectively on that person’s life instead of the methodology of death.

Pakistan Tehreek-e-Insaf’s then presidential nominee, Arif Alvi, had publicly suggested a readily available 24/7 psychiatric helpline in September 2018. In November 2018, the President, while addressing the 22nd International Psychiatric Conference organised by Pakistan Psychiatric Society (PPS) said that everyone should play his role for establishing a healthier society in the country. The government can and must play its role too in this regard, and the media can play its role by reminding policymakers and those in positions of power to recognise that mental health must be put on the forefront of the list of priorities when it comes to public health.

WHO’s 2014 report, “Preventing suicide: a global imperative” estimates that for every suicide there are at least 10–20 acts of Deliberate Self Harm (DSH). By this estimate, there may be between 130,000 to 270,000 acts of DSH in Pakistan annually. This means that there are signs before the actual act of suicide is completed. Journalists must include then, after consulting a mental health doctor or therapist, some points about how to recognise the signs that a person may be inching towards suicide, and what can be done to help such a person. The reader can also be directed towards Suicide Prevention Helplines.

Reporting on suicide, and mental health issues, is a huge responsibility, as well as an opportunity to make a difference. These are not stories to be sensationalised. These are not lifestyle or entertainment stories. These are stories that come under the beat of “health”. Once journalists recognise this, the reporting will become more responsible. Most importantly, out of these dark and seemingly hopeless news stories, there can emerge a ray of hope — the hope that if reporting is done intelligently and carefully, it may help spread much needed awareness. It may help someone out there. It may help save a life.

http://tns.thenews.com.pk/time-sensationalise/#.XDxIJbhS81k

Antibiotic overkill – How Pakistanis are putting themselves at risk of antibiotic resistance

Treatment for viral diseases is leading to drug-resistant infections

Antibiotic overkill
We are sitting on the brink of a health disaster. Humans may again reach a stage where even small cuts, minor injuries and seemingly innocuous infections can prove to be killers — all of these are conditions that can be effectively treated by antibiotics. Misuse and overuse of antibiotics is building in our systems resistance to these drugs and a time comes when these medicines are no longer effective in fighting the bacteria and infections they were designed to ward off.

Antibiotic resistance is leading to untreatable infections. Any age group can be affected by it. If care and caution is not exercised in the use of antibiotics, humans could be in serious trouble. We already are, if numbers are to be believed. Self-medication and use of antibiotics without thinking twice is a problem. The fact that Pakistan has, as reported by the Pakistan Medical Association, more than 600,000 quacks who pose as doctors and prescribe antibiotics without any need or deliberation, exacerbates the issue.antibiotic-awareness-poster 1

It is very common practice to go to “pharmacies” which are usually counters in grocery stores, run by people who are not pharmacists, and ask for any random antibiotic that the patient feels “suits” him or her. While it may have been effective the last time you used it, and the time before that, this time it may not work as you have developed resistance to it.

“We see a lot of antibiotic misuse at the hands of general practitioners as well as quacks. The urgency to use antibiotic sometimes also arises from patients demanding that they return with some medication if they have visited a doctor,” says Dr. Nosheen Nasir, Senior Instructor, Adult Infectious Diseases at the Aga Khan University (AKU).

“We see antibiotics being used for viral upper respiratory tract infections and for presumed enteric fever based on typhidot results which are erroneous and misleading.” Dr Nasir adds that antibiotic overuse can lead to increase in drug-resistant infections and significantly increase the risk of morbidity mortality. “Infections which were previously simple to treat now require use of more toxic and expensive antibiotics which are usually given intravenously, leading to unnecessary prolonged hospitalisations.”

World Antibiotic Awareness Week (WAAW), held from November 12 to 18 this year, aims at increasing global awareness of antibiotic resistance, AMR (Antimicrobial resistance) and to encourage best practices. AMR occurs when microbes, such as bacteria, become resistant to the drugs used to treat them. The 2018 WAAW campaign has two key messages: “Think twice. Seek Advice” and “Misuse of Antibiotics puts us all at Risk”.

AMR, as Dr. Nasir adds, refers to resistance among all kinds of micro organisms such as bacteria, fungi, parasites etc. when they are exposed to antimicrobials including antibiotics and antifungals.

She shares an example of antimicrobial resistance that we are facing today in Pakistan. “People get a lot of antibiotics unnecessarily for presumed typhoid fever, also called enteric fever. This has led to a country-wide outbreak of extended drug resistant (XDR) typhoid fever, sensitive to only two antibiotics, one of which can only be given intravenously. This has led to serious life threatening infections particularly in children,” she says.

November 2018 also saw “Call to Action on Antimicrobial Resistance” from November 19 to 20, co-hosted as a second global event by the UN Foundation to help drive action to stop the rise and spread of superbugs. Dr. Fatima Mir, Assistant Professor of Pediatric Infectious Disease at the AKU, explains that “Super bugs are germs which over time have become resistant to common antibiotics through new mechanisms.” She cites some of the lethal super bugs in Pakistan as under:

1.Multidrug resistant gram negative organisms like klebsiella pneumoniae, e.coli and serratia, leading to newborn sepsis.

2.Extended spectrum beta lactamase inhibiting (ESBL) gram negatives like e.coli, klebsiella, enterobactor sp, which can cause gut, abdominal and urine infections in all ages

3.Penicillin resistant streptococcus pneumonia, causing lower respiratory tract infections in all ages

4.Multidrug resistant Typhoid, effecting all ages

5.Multidrug resistant Tuberculosis (TB), affecting all ages

In Dr Mir’s professional experience, Pakistanis generally have a tendency to hurry towards antibiotics, “Especially in cases of Upper Respiratory tract illnesses which are usually viral but also associated with symptoms which make one miserable, like congested nose, throat and body aches, parents feel kids won’t get better without antibiotics, and most physicians succumb to pressure and prescribe antibiotics even for clearly viral illnesses.” She adds that one reason for over prescription is lack of low-cost testing to establish a viral cause. “Usually a full course of antibiotics is cheaper than a test for a single viral antigen, so physicians make a misplaced choice of empiric antibiotics to appease parents (of child patients) in place of expensive testing for an essentially self-resolving viral illness,” she says.antibiotic-awareness-poster 1

The problem of resistance to drugs affects all age groups. The elderly are not spared either. Only tests conducted in the laboratory can confirm whether the cause is viral or bacterial. Lack of mobility of elders to go or be taken to laboratories, plus general caretaker fatigue that sets in when an elderly patient has been dependent for long, means a lot of elderly people end up getting even fewer lab tests run on them than patients of other ages.

The easiest way out is to start them on antibiotics without getting even a simple test done like the “culture” which tells which antibiotics would still be effective for that particular patient. “As older patients may not manifest with typical symptoms of infection, antibiotics are frequently given often causing antibiotic resistance. They often may not have fever, and the infection may only manifest as weakness. This practice can be curbed if investigations are done early to confirm infection prior to starting antibiotic,” says Dr Saniya Sabzwari, Geriatric Specialist at the AKU.

In 2017, a “National Action Plan” was drafted by the Health Ministry in Pakistan to fight antimicrobial resistance, developed in the light of the five strategic objectives listed by the World Health Organisation’s (WHO) Global Action Plan for AMR.

Between the years 2000 and 2010, global consumption of antibiotics has increased by 30 per cent. Some 700,000 people die every year from infections that don’t respond to antibiotics. If this is not controlled, AMR could cause 10 million deaths each year by 2050; this number would be more than the deaths caused by cancer.

While over-dosage leads to antibiotic resistance and other serious side effects, under-dosing is a problem too. “This means that the drug, even if chosen correctly, is ineffective because it cannot reach effective concentration in blood. Incorrect dosage is one of the main contributors to antibiotic resistance in addition to incorrect usage,” says Dr. Mir.

http://tns.thenews.com.pk/antibiotic-overkill-2/?fbclid=IwAR2-HxUffRu4YBqq28ssqZof7LnKQDMCoG04GsvnvS_FnQt-pKNWEyBIW-Q#.XAJgG81oQ1k

Wearing second hat as family’s sole breadwinner

November 12, 2018

ASIYA’S day starts at 5.30am. She says her prayers, cooks breakfast for her family, and a curry for dinner, wakes up her three children, feeds them, sends them to school, and then cleans her one-room rented accommodation in a shanty town of Karachi. She leaves home at 9am to work as a domestic helper, and gets back by 6pm. Then onwards, household chores keep her occupied.

Her husband doesn’t have a job since they moved from south Punjab to Karachi. Yet, she is the one doing double duty, managing her home and wearing a second hat as the family’s sole breadwinner.

“Time for myself? Never thought about it,” she says. Her monthly salary is Rs20,000 ($150).

Across a few roads where more affluent Karachiites reside lives Saima (name changed) who earns six times as much as Asiya, her monthly salary as an assistant manager at a multinational firm touching Rs120,000 ($900), more than what her husband earns. Yet Saima’s routine is pretty similar to Asiya’s. In addition she is a caretaker to her elderly mother-in-law once she is back from work.

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UNDP’s human development report highlights that care work, mostly undertaken by women, is what enables a majority of the paid work which drives economies. Yet, as it is unpaid, it is under-documented and taken for granted. According to a recent report by the International Labour Organisa­tion (ILO), globally women perform 76.2 per cent of total hours of unpaid care work, more than three times as much as men.

In Asia and the Pacific, this rises to 80pc, where women spend 4.1 times more time in unpaid care work than men. Around the world, women spend two to 10 times more time on unpaid care work than men. Countries have valued unpaid care work between 15 and 39pc of national GDP.

At the recent United Nations World Data Forum 2018 hosted by the UAE government, Gender Data remained at the forefront of discussion as more than 2000 academics, statisticians, and activists from both the public and private sectors globally sat down to discuss the impact of data, especially Gender Data. Data2X, led by the United Nations Foundation, is a key organisation among Gender Data initiatives, and defines Gender Data as “data that is disaggregated by sex (e.g. school enrollment by sex), as well as data that pertains specifically to women and girls (e.g. maternal mortality rates). This data is critical to determining the size and nature of social and economic problems, the causes and consequences of those problems, how to design policies to combat them, and the effectiveness and cost-effectiveness of those policies”.

While the Pakistan government strives to get over its economic crises and the subsequent cost on human development, half of the country’s population — women — and data related to their needs and their economic contribution remains mostly missing.

Women’s rights proponents like Ume Laila Azhar, Executive Director of Home Net Pakistan, highlight these issues at the policy level.

“If women are counted in statistics, their work must be counted too,” she says. Ms Azhar adds that in the Human Development Index, if women are not recorded in the labour participation figures, it shows low female participation. “If the numbers of women in the work force appear to be too small, women are not considered at the policy level — policies that translate into job opportunities or initiatives for skill development for women,” she says.

Time Use Surveys (TUS), an important tool in this regard, measure how, on an average, people spend their 24 hours in what activities. “TUS are the best instrument to measure unpaid care work, since they measure the time people spent on this work,” says Mayra Buvinic, senior fellow at Data2X and an internationally recognised expert on gender and development. Linking the dots of TUS to the evaluation of unpaid work, Ms Buvinic says that by assigning a value to unpaid care work, “you make this work visible to policymakers who design policies to increase labour force participation rates and provide social services, including paid care services”. “Unpaid care needs to be factored in the design of these policies since it conflicts with labour force participation and it provides an estimate of the need for child and elder care,” she adds.

The 17 Sustainable Development Goals (SDGs) target to improve women’s lives by encouraging their economic participation and financial inclusion. Gender Data is an important tool in the achievement of the SDGs.

A recent tweet by philanthropist Shaniera Akram resonated with the twitterati where she mentioned how women’s multi-tasking and contribution is undervalued. Speaking with Dawn, Ms Akram says that women are often overworked and under-appreciated, not just in Pakistan but all over the world.

“Women can’t be taken for granted anymore. Men can’t just take all the credit, especially when the women — mother, daughter or wife — are taking care of everything behind the scenes,” she says, suggesting that society will benefit from incentivising staying home and taking care of children, the elderly and sick or disabled relatives, with a domestic allowance for women.

“We must focus on getting to a point where women don’t just have the right but also the choice between wanting to stay at home and going into the formal work force,” she adds.

“When families in rural Sindh or Punjab work on lands of landlords with tenancy arrangements, the whole household is working — including the women and children — whose contribution isn’t counted,” points out Ms Azhar. Rural women do a lot of unpaid work like growing vegetables for food sustenance, looking after cattle and milking cows, doing not double but triple duties.

“A woman overworking is a form of exploitation, and she doesn’t get the respect and acknowledgement she deserves for her contribution,” she says.

The author is a freelance writer and her work can be seen at chaaidaani.­wordpress.com

 

The first 1000 days & after: How hunger effects brain development

The crippling effects of hunger on brain development, and in turn on education, employment and quality of life, become worse if certain vitamins and nutrients are missing

The first 1000 days and after

The image of an emaciated, almost wasted, skinny child comes to mind when we talk of malnourished children — children with thin arms, protruding bellies, and light-coloured hair. Yet, the price malnourished children, their parents, and entire nations pay is far more than just what is apparent.

A malnourished child’s ruling organ, the brain, does not develop at an optimal level due to lack of sufficient nutrition. All stakeholders continue to pay the price for decades to come — both on a personal and a collective economic level. Malnourishment, then, may be the silent and neglected brain drain that no one is talking about.

According to Dr Irshad Danish, National Coordinator, Scaling up Nutrition (SUN) Civil Society Alliance, Pakistan, stunted children have 7-months delay in starting school, have lower intelligence quotient (IQ), are more likely to repeat a grade of school, complete one year less of schooling on an average, and are less likely to graduate high school.

“The effects of malnourishment include a low IQ, poor concentration, attention deficit, and memory disorders,” he says. Mentioning the findings of a report launched by the Pakistan Scaling Up Nutrition (SUN) Secretariat at the Ministry of Planning Development & Reform, in collaboration with the United Nations World Food Program (WFP), he adds that the consequences of malnutrition — including healthcare expenses and lower productivity — cost Pakistan US$7.6 billion, or 3 per cent of GDP, every year.

He says that children who are malnourished learn less at school and earn less when they grow up. Iron and Iodine deficiency in childhood reduces IQ by up to 25 and 13 points respectively. Cognitive deficits from childhood stunting, anemia and iodine deficiency disorders depress future adult productivity, valued at Net Present Value of $3.7 billion per year.

Brain development of the foetus starts in the womb of the mother, particularly in the third trimester, explains Dr D.S. Akram, Founder, Health, Education & Literacy Programme (HELP). “If the mother is malnourished and anemic, there are more chances that the brain growth will not be optimal as insufficient hemoglobin in the mother’s blood means insufficient oxygen for the foetus,” she says, further adding that between the age of three to six months, the baby’s brain grows rapidly, and if there are factors like a malnourished mother, premature birth of the child, or the mother not exclusively breastfeeding the child for the first six months, brain growth may slow down.

Dr Akram also says that if the child does not receive enough food as well as brain stimulus in the first two years, it may lag behind in its key developmental milestones. “When the child goes to school, his ability to perceive, to memorise, his motor skills — all will be slow. This will result in a lack of motivation in the child who will not experience the pleasure of learning. It’s a vicious cycle,” she says. For optimal brain development, according to her, it is imperative that timely introduction of a balanced diet of solid food is introduced, containing micro-nutrients, proteins and fats.

Solutions include early initiation of breastfeeding, exclusive breastfeeding for six months, starting complimentary feeding after six months, and continuing breastfeeding for two years.

Quantifying the link between brain function, academic performance and malnourishment, the Hunger in the Classroom report, 2015, by Food Bank Australia, stated that over two thirds of students who miss out on breakfast can find it difficult to concentrate (73 per cent) or can become lethargic (66 per cent), with over half experiencing learning difficulties (54 per cent) or exhibiting behavioural problems (52 per cent).

Perhaps this is why for Saeed Qureshi, the most rewarding part of his decade-long service of leading Aman Ghar (an initiative of the Aman Foundation), was working on feeding underprivileged school-going children in Karachi.

Since last year, Aman Ghar joined hands with Saylani Welfare International Trust, and meals are distributed to deserving students of 15 schools, which serves both as an incentive for children to come to school, as well as helps them perform better at school. Aman Ghar’s motto has been “food for education”.

Qureshi explains that before the inclusion of the lunch programme, the students were reported to pass out during school hours due to hunger, especially in the summers. Since the lunch programme started, there has been a significant change in the academic performance of the students. “I have seen children come to school on a hungry stomach, eating only paapay (rusks) and chai (tea) at most. Their decision power is impacted as is their ability to shine academically. They are dull and tired, and cannot participate in sports.”

Qureshi says that they mix four kinds of grains to make roti for the wraps for the children, which make up for deficiencies like iron and niacin that boost brain activity. “We have also tried to incorporate leafy vegetables, pulses, and meat in the diet,” he informs.

The crippling effects of hunger on brain development, and in turn on education, employment and quality of life, become worse if certain vitamins and nutrients are missing. Neurologic deficits can be a result of deficiencies in micronutrients like folic acid, iodine, iron, zinc, selenium, copper, magnesium, vitamins A, C, D, E, B6 and B12.

These deficiencies can result in learning disabilities, mental retardation, abnormal levels of cognitive and mental functioning, and even depression, anxiety and withdrawal, all detrimental to a child’s focus on academic activity. Malnourishment can also result in behavioural issues, and lapses in memory and concentration.

When asked how parents can avoid this happening to their children, Dr Danish says that “the first 1,000 days between pregnancy and a child’s 2nd birthday sets the life-long foundation for human capital. After two years of age, the impacts of stunting are irreversible”.

In his opinion, solutions include early initiation of breastfeeding, exclusive breastfeeding for six months, starting complimentary feeding after six months, and continuing breastfeeding for two years. Also, it is important to avoid junk foods and sugary drinks, provide diverse and nutritious balance food which should have necessary amount of proteins, vitamins, minerals and carbohydrates, and consume milk, fruits and vegetables.

“If all relevant stakeholders work together and implement joint interventions for nutrition, we can avoid bad impact of malnutrition on learning, earning and health,” says Dr Danish.

 

http://tns.thenews.com.pk/first-1000-days/?fbclid=IwAR3DSapGsbpLrzaobOQxPG3LlD8d0bgoADYqOyzrpcD649V8yYYunBG3W-w#.XAJckc1oQ1l

 

Imran Khan: The human-centric Prime Minister

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Imran Khan has been sworn in after a struggle of more than two decades, and his first speech in the National Assembly, muffled by a verbal mob attack from PML-N’s parliamentarians, is being criticized for rotating backwards to the agenda of corruption. Khan’s rise to power is being seen as resting on the narrative built around fighting corruption. But look closely at one of his more shining moments – his victory speech after most of the results of General Elections 2018 were in, lauded by supporters and critics alike. The core agenda, there, was not just corruption. It was human development. If we join the dots, Khan’s sloganeering against corruption has always led to one single point of convergence: Let’s get back the nation’s money from those who usurped it, and spend it on human development. In Khan, then, Pakistan may well have its most human-centric prime minister to date.

Consider the man’s journey from November 10, 1989, when he made a nation-wide appeal for the collection of funds from a match between Pakistan and India on at Gaddafi Stadium, Lahore, to start collection of money for the cancer hospital he wanted to establish. Some five years later, Shaukat Khanum Memorial Trust Hospital opened its doors for the first time. The philanthropic spending to date at SKMT has been Rs 32.835 billion (US$ 371 Million). Namal College in his home district of Mianwali followed, and is a success story in itself. This has been Khan’s focus in life apart from his relentless and eventually successful efforts at changing the country’s political landscape from the platform of his party, Pakistan Tehreek-e-Insaf (PTI).

Perhaps no human is actually ever altruistic, and whatever good that we do for others is actually done because it makes us feel good about ourselves. And Khan is as human as they come. Combustible, emotional, flawed, egoistic, and duly criticized for all of this across the board. But he is also quintessentially gritty, dedicated, committed, sincere and kindhearted. Whether his passion for social causes like public health and education is altruistically driven, and why he invests so much of himself in the human-centric approach, would be a futile and lengthy psychoanalysis. But this human-centric approach, if properly used, can mean definitely better tomorrows for Pakistan’s people, and that is what we must reflect upon.

Look at just a few examples from Khyber-Pakhtunkhwa (KP) under the reign of the PTI from 2013 to 2018. The Sehat Sahulat card is KP government’s flagship health insurance programme, very low on premiums, that allows families to utilise up to a decent sum of PKR 540,000 per annum, not in public sector but also private sector hospitals and healthcare facilities. On a broader level, PTI’s establishing the Right to Public Services Commission has been an effective move. Responsible government functionaries can get penalised if services are not provided to citizens promptly. Some of the public services in this regard include issuance of domicile, death and birth certificates, approval of residential building plans, OPD and Emergency services, release zakat funds, grant of Jahez fund, water connection, clean drinking water, disposal of garbage/solid waste, and issuance of wood permit for construction of house. In an earlier report, Atif Khan, the then Minister for Education, KP, had shared that education of girls was prioritised by the PTI-led provincial government. He had mentioned that 70 per cent of all new schools the government is 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. As an incentive, female education managers in backward districts like Kohistan were being paid 50 per cent extra.

In the 100-Days plan the PTI unveiled a couple of months short of the General Elections was perhaps too ambitious, and even idealistic. Yet, the path was clear. It was mostly focused on human development. In fact even when PTI talks of economic stability and financial growth in the country, the dot is joined to ideas like creation of jobs, especially for the youth, construction of houses, and availability of quality education and healthcare for all Pakistanis. What they are presenting the plan for, then, is infrastructure and business growth that, in turn, helps work on the human capital of the country. For too long there has been a lopsided focus on the building of infrastructure and material expressions of development, but somewhere the average Pakistani got lost. Whatever work was done in the past by previous rulers (leaders would be a debatable and probably refutable term) was clearly not enough. Under the pressure of social media and induced awareness, previous governments sporadically and isolatedly did some work in areas like health and education, it was never the singular focus. Today it is, and this is a refreshing change for Pakistan. A Tabdeeli (change) that one hopes and prays the PTI government, under Imran Khan, is able to pull off, and put into action.


The author is a freelance journalist, media trainer and communications practitioner. Her focus is human-centric stories.

https://www.thenews.com.pk/latest/358248-imran-khan-the-human-centric-prime-minister?fbclid=IwAR1wMlVkwA6VR0V4h-lox8RU9ZRFRSI_O_k00nCJQRbmEdPMEdlU8V-AR0E

Pakistan’s fast changing kitchen-scape

Hiring cooks does not mean women, or men, are not homely any more. It is a social change, one that we must accept, and see cooking as an emerging, respected profession

The fast changing kitchen-scape

Once upon a time I used to cook up things like a mean deg of nihari, loads of bihari kabab, and the genuinely ghutta hua haleem for a dinner for 30 people quite frequently and without panicking. If I had a helper to cut up the onions and vegetables and wash the meat and do the dishes, I was good to go, taking smugly all the compliments that came my way.

But somewhere along the road, priorities changed. It was not just the fact that I became more invested in my profession. It was also not just me. The emergence of “cooks” came to the fore.

No, these were not the live-in Khan-e-Samaan breed of cooks that our mothers and grandmothers had who used to manage the entire kitchen and cater to all food-based needs of big families. These are part-timers. A few hours a day or a week. Neatly stacked storage boxes of salan and kabab split into portions in the fridge and freezer, also labelled for convenience. This is what the modern-day cooks on urban Pakistan are like.

Often one doesn’t have one but actually many. I have one in my list of contacts in my phone that is for usual day-to-day cooking — the chawal, daal, sabzi, qeema type of stuff. Then there’s the one you call when there is a dinner at home — biryani, kabab, qorma and the likes of these. But then there’s the super fancy one — the CV or intro says, “can make Chinese, Thai and oriental food”. I have not utilised services of all but there is a comfort in knowing they are there.

In a fast-changing social landscape, the larger joint families have been replaced by nuclear families. In these urban families crunching under inflation, the woman no longer has time to deliberate about the daily menu, then cook it, and then serve it. She is as much an earning member of the household as her husband. Many a times, even the children, once they are young adults, are working part-time.

The good thing that has come out of this is that unnatural expectations from women to focus their lives only around the kitchen and its periphery are decreasing. But that also means cooks are an integral part of life. However, full-time cooks are expensive in more ways than one. Not only is it the salary, but it is also the unsaid pressure to get food cooked daily in order to justify why you have that full-time cook.

It is an expensive proposition to house domestic staff. Thus, part-time cooks seem like a great option — both for the employer and the employee. For the employee as being able to work in more than one house allows him or her more flexibility of timings, and is mostly a more lucrative option.

The good thing that has come out of this is that unnatural expectations from women to focus their lives only around the kitchen and its periphery are decreasing. But that also means cooks are an integral part of life.

A faster-paced lifestyle also means we are less discerning about many things — we don’t get our masalas pounded at home; we are ready to buy ‘heat and eat’ items, and we use a lot of easy-to-cook meat options, mainly poultry. Fried onion packets have found a way in our homes, as have frozen chopped vegetables. Plus we eat out way more than our counterparts a few generations ago.

Pakistanis are serious about their food so it is not that cooking has taken a back seat. However, other more pressing things have taken precedence. We still cook, but now it is more sporadic, and limited to certain specialties to remind our families and ourselves that we still have not forgotten how to make food. Hiring cooks does not mean women, or men, are not homely any more. It is a social change, one that we must accept, and see cooking as an emerging, respected profession.

http://tns.thenews.com.pk/fast-changing-kitchen-scape/?fbclid=IwAR164tl3DjPcZGwjGbfv9XCe6Cp6k8fkmpwmFfbRDZZ9CCDSbphQ1zCj-BA#.XAJZic1oQ1l