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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

“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

#MeToo, #JahezKhoriBandKaro, #NotFunny: Lifting the curtain of sexism in Pakistan

 Published: March 8, 2019
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Jokes that demean women, perpetuate stereotypes about women, and degrade women, are just not funny.

Hashtags make a difference, and for campaigns regarding the rights of women, the last one year has seen some important hashtags that made us sit up straight. The most recent one is #NotFunny, an awareness campaign launched on National Women’s Day by the Uks Research Centre, pointing out aptly that enough is enough – that jokes that demean women, perpetuate stereotypes about women and degrade women, are just not funny.

S☆S 🇵🇰🇹🇷@jiyyah_shaah

Yes Absolutely 🖒

See S☆S 🇵🇰🇹🇷‘s other Tweets

For those who consider themselves more ‘evolved’ or ‘aware’, the litmus test can be something as seemingly small as the jokes men keep forwarding on chat groups – ‘guy jokes’ that talk of women as objects of desire and reek of in-built sexism and misogyny. This would importantly also include women rejecting the idea that such jokes are ‘normal’.

Another hashtag emerged towards the tail end of 2018 – #JahezKhoriBandKaro, shedding light on the issue of jahez/dowry, a menace that may have reduced slightly or may have changed forms and names, but still very much exists in society.  

The most popular hashtag globally has been #MeToo, of course. It took women like me almost a year to understand what a big deal the #MeToo movement is. Women like myself comprise of relatively educated, aware, self-proclaimed and empowered women and even journalists who have been writing on gender issues, ensuring that the voices of women are heard.

As the #MeToo movement started trending globally, journalists in Pakistan also took to Twitter to share their thoughts on the movement:

Reham Khan

@RehamKhan1

Sexual harassment is not understood. Both men & women need to be educated about what constitutes harassment based on gender.

Ever since this hashtag started trending on Twitter in 2017, thanks to the American actress Alyssa Milano, many of us began to rethink and question our understanding of so many concepts. Some of us, for instance, began to wonder what exactly constitutes as sexual harassment, if we experienced it, should we say it out loud, and if yes, then why?

As female journalists, many of us have come across instances, not necessarily as subjects but even as bystanders, where we may have felt uncomfortable by a gesture, a sentence or a physical nuance of a man. We were encouraged, even less than a decade ago, to not “overthink” because “that’s just how men are”.

For women who chose to work in professional spheres, the situation was far worse  a compliment that was not welcome, a handshake that bordered on being forced, an insistence for company over coffee, a stare across the room in a meeting or an unsolicited text message or phone call, were all a part of our daily work routine.

Back then, we did not consider any of these things to be harassment, and even if this thought did occur to us, these were just other things to be brushed under the carpet.

But this carpet has now been lifted.

For far too long women have been bearing with this, speaking out only if something crossed the ‘upper limits’ of their threshold, and then living with the consequences in both their work and private lives.

While laws and hashtags are important, they are not enough, and can only take us so far. Sensitising both men and women is perhaps the first step, and this process has to start early. Young girls must be taught to say ‘no’, and young boys must be taught to accept ‘no’ instead of considering it their right as part of  ‘male entitlement ’. Parents, schools, and even society will have to play a role in teaching these things.

Jokes about women being money-hungry bimbos, dependent drama queens, or simply even sexual objects, will have to be especially discouraged.

#MeToo has become a space for women to air their grievances, and for catharsis of unpleasant experiences they have remained silent about. A woman may choose not to use the hashtag #MeToo, and has the right to not disclose anything.

However, this movement allowed those who want to say it out loud/speak out against their harassers, to go ahead and say it/do it and this in itself is progress. Acknowledgment and validation of the fact that sexual harassment or sexist jokes and misogyny exist is definitely a step in the right direction.

A narrative is steadily building around it, and the most unexpected of people now at least know what this means. In spite of the debate and controversy that the movement has generated-added, the conversation has at least begun, and the debate has at least started to gain momentum.

Consent has been central to our understanding of women, yet it has not been delved into enough. The idea of consent needs to be dissected and understood, and in this context, ‘touch’ is very important.

Should men be careful before extending their hand for a handshake? Does close proximity make the other person uncomfortable? Do male doctors or medical technicians need to ask the female patient before they touch her for medical reasons?

Is casual flirtation okay? Can we get away with telling our colleague “I was just giving you a compliment” or “I was just kidding”, when we have in fact made her visibly uncomfortable?

Are there boundaries and limits that can co-exist alongside the ideal of a comfortable workplace environment for both sexes? Questions are being raised. Answers may not have been established yet but the conversation has begun.

That being said, many people still don’t agree with the stance of these movements. On social media, insensitive attitudes can be seen in comments and tweets from both males and females. Often these tweets reek of a lack of understanding of the issue.

Those who are generally more conservative in terms of thinking look at it as ‘an issue being made out of nothing’ and raise the insensitive question of: “why did she complain now after all these years?”

What needs to be understood is that the idea behind saying it out loud is not just to punish men. It is in fact a means of providing catharsis and healing, and setting precedents for women faced with similar situations.

Much remains to be done, especially in terms of social attitudes. Seemingly small reactions from society discourage women to voice that they have felt harassed at some point in their lives.

I remember a colleague talking to me once about how she had been harassed, and what was shocking for me was that she was almost apologetic while saying,

“I don’t know why he would harass me, I am not even good looking”.

Others are too afraid to talk about it or do not want to talk about it because of the common responses: “It is never one-sided”, “she must have done something to provoke him” or “she seems like modern woman”. Sadly, the onus is placed mostly on the woman to ensure that the man keeps himself in check.

Awareness does make a difference, and we may be inching towards better times, but we still have a long way to go.

Happy Women’s Day!

https://blogs.tribune.com.pk/story/79435/metoo-jahezkhoribandkaro-notfunny-lifting-the-curtain-of-sexism-in-pakistan/

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

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.

 

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