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#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/

Cost for consumers – Inflation in Pakistan effects wants or needs?

For the bourgeois and the patricians of Pakistan, their reaction to inflation is as different as is their lifestyle

The cost for consumer

“What has hit me and my family most is the price of milk and sugar going up in the last two years,” says Zainab Bibi who hails from Mailsi district in South of Punjab. She and her husband moved to Karachi a few years ago in search of a better standard of living. But for Zainab, an avid tea drinker whose staple diet continues to be chaai paratha, it is not easy surviving in Karachi as items that make up her sticky sweet tea are pricier than in her village. “One reason I came here is that I want to save enough to build two rooms in my village, my own home. But the price per 1000 red bricks has risen from Rs5000 to Rs8000 within two years.”

In contrast to Zainab’s economic challenges, the challenge of Samiya Khan (name changed), a resident of the uptown Defence area in Karachi is different. “You are asking the wrong person. I honestly have not felt the pinch as my husband just gives me his card; I go to the supermarket and swipe it to pay without even checking the prices minutely. But if at all, I would say the prices of imported food items have gone up. The chocolate spread my children love eating and I use for baking cupcakes has gone up from Rs280 to Rs450. However, I don’t think prices have gone up that much. Have they?” she says.

Prices of consumer goods, utilities and luxury items going up is never taken lightly. But which prices affect which strata of society is the key to understanding how closely linked income inequality and inflation are.

Pakistan’s annual inflation rate rose to 7.2 percent in January of 2019 from 6.17 percent in the previous month. It was the highest inflation rate since September of 2014, as shared by Trading Economics. According to the State Bank of Pakistan’s website, Headline CPI (Consumer Price Index) inflation (2007-08=100) was recorded at a level of 6.2 percent on year-on-year basis in December 2018 as compared to 4.6 percent during corresponding month of last year.

According to data shared by Pakistan Bureau of Statistics (PBS), January 2019 saw an increase in prices of items like sugar, fresh fruits, pulses and tomatoes, but also saw a decrease in the prices of chicken (by 18.06 percent), eggs, onions and potatoes.

But for Zainab Bibi, all this does not translate into a major change, and the one underlying take home message she has in her mind is simple — A good life in Naya Pakistan is as unaffordable as purana Pakistan, even though fuel prices have gone down although electricity prices have gone up if compared between December 2018 and January 2019.

For the bourgeois and the patricians of Pakistan, their reaction to inflation is as different as is their lifestyle when compared to the struggling lower middle class or the yet lower strata on the economic ladder. When asked which household needs had taken a dent due to inflation in Pakistan, the elite is often found themselves confused between needs and wants, and often complain of how luxury spending has been affected.

It is not that the well-off people do not get impacted by inflation. The price of fuel affects the prices of water tankers for the upper tier. When this happens, their lush lawns become parched, they stop washing their car porches frequently.

Over lavish high-teas, the conversations often include how the price of air travel has gone up, and vacations are becoming pricier. Delve deeper and the falling rate of the Pak rupee has affected how they will pay the fee of their children studying abroad in dollars and pounds. “I am very happy actually; my children’s school fee has been considerably reduced since the new government came in,” says a young mother whose two children are students at an upper tier school in Karachi.

What varies is the pinch someone feels when prices go up, depending on affordability. The theory of relativity may then not be applicable only to laws of physics, neutrons and black holes. How every Pakistani experiences inflation is in relation with how much they can afford, their spending habits, and their bank statement, if they have a bank account, that is.

Yet one strata feeling the hit of inflation does spill over to the other strata as well. When a darzi (tailor) increases the rate of a female shalwar kameez, the pinch is felt by all, but few join the dots that the cost of commute of the tailor and his assistants has gone up because petrol is pricey. The ticket for a bus traveller, the fare for a rikshaw commuter, or the cost of fuel for someone who goes on a motorbike — all go up. Consequently, so do the prices of general household items.

It is not that the well-off people do not get impacted by inflation. The price of fuel affects the prices of water tankers for the upper tier. When this happens, their lush lawns become comparatively parched, they stop washing their car porches frequently, and they opt for ‘made in Pakistan’ semi-automatic washing machines to save water. If fuel is pricier, one thinks twice before opting for the generator during long sultry hours of load shedding, and opts for the UPS. And if electricity rates climb up, the use of air conditioners has to be well thought-out. Last if not the least, climbing rates of gas means affluent Pakistanis are actually considering opting for smaller water-heater geysers that can be easily put on and off as and when needed.

But for those who have to start worrying about the prices of potatoes and ghee, and have far too many mouths to feed but way too less earning hands, inflation is a bad word. It is time those on top of the food chain let some resources trickle down to make life easier for all. We may not be able to reduce inflation, but maybe we can somewhat reduce the widening economic inequality.

http://tns.thenews.com.pk/cost-consumer/#.XKW4wZgzbIU

Millenials vs Us – How weddings in Pakistan have changed

Without over-spending and showing off, one can still have a fun, festive, joyous wedding

Millenials and us

There is always a level of naivety at a young age. The stars in our eyes cloud our vision. Yet today’s generation is smarter in some ways, if not all, than us. For starters, they know that after the “wedding” there is something called “marriage”. Back then, we had one single word for both very different concepts — shaadi.

For us, shaadi meant the rasoomaat (traditional wedding rituals), the dresses, the jahez and bari (yes, we come from that stone age era where jahez was not a bad word and was politically correct, and bari was a given). Our focus was the wedding and not so much the marriage as we set off on our, perhaps, most important journey that was to change the course of our lives.

So here are the pros and cons — on a comparative level — between the age of innocence (or stupidity) and the age of the so-called Generation Y (our smarter counterparts).

The Net Generation knows, for the most part, what it wants out of life. They have definitive goals, and marriage is, for most if not all of them, ONE of their many goals. For us, it was THE most important goal. This is why the wedding hype in our over-dramatic times was emotionally exaggerated. The crying at the time of rukhsati was a given. It’s not that brides today won’t miss their folks but the make-up is a result of either parents or the by-now-earning bride working hard to pay the make-up artist loads of money. Loads are always relative, of course. Today’s bride cannot afford to faint in sadness at rukhsati time. She knows that some 20k went just into her dupatta fixing and jewellery setting. She got the appointment a year in advance. It’s not worth it to get the mascara to flow. Besides, crying can be done on another day.

The millenials are also very clear in terms of who they want present on the wedding. Their “friends” are key. It’s ok upto phuphichachimaami and khala. And cousins are always good fun. But they don’t want distant relatives or neighbours of an area the parents left 20 years ago. They want smaller but “classier” weddings. They’d rather spend on the flowers than on people who don’t mean much.

The brides today are also smarter in that they are not big on gold jewellery because prices of gold have skyrocketed. So they are smart enough to use silver that is gold-plated. They also wear one carefully selected set. ONE. As opposed to brides of my generation wearing like 5 necklaces on any given shaadi.

The brides today are decidedly more elegant. The groom is more well-groomed, really. The couple portraits are more picturesque at smartly chosen locations. Their invitees are more select. They know that weddings lead to marriage. They are simply smarter. Or are they?

While the weddings of millenials are smarter, the old world charm has been lost in some aspects. Just take the excessively choreographed mehndis for one that seem more for Instagram and snapchat and less for the simple joy of unrehearsed celebration that came out of spontaneous luddi and singing tappay. The dholkis have everything but a dholak.

While smaller weddings are a great idea, they would truly be great only if they are less ostentatious and lighter on the pocket. We invite less people but end up spending more money. The event management, flowers and elaborate menus from upper tier caterers are a huge burden on the families. Even if one can afford it all, is it a must that we spend not lacs but millions? Also, there was a certain warmth in inviting relatives and old neighbours. One can and may limit the number of people, but why leave out those who have been a part of the lives of these families? The rasoomaat are debatable for many reasons — religious, cultural or due to social evolution. But the joy of sharing this momentous occasion is a pre-requisite.

While we laud the weddings of today on account of some smarter choices, are these choices really pragmatic, or has our extravagance simply changed forms? The jewellery may now be gold-plated silver, and it may be a single set the bride wears, but what about the wedding dress that takes years to plan and order, and costs a fortune, and is so heavily full of work that it provides no visual relief, yet is something we don’t seem to mind.

Earlier it was jahez. Now it is expensive wedding dresses by designers and elaborate wedding events. Have we actually had a paradigm shift socially? Look closely and nothing has really changed. Weddings are a pricier affair than ever.

And while the millenials are smarter in their life choices, they are sometimes so smart that leave alone wedding, they doubt if even marriage is a good idea, because it has simply too many strings attached, and is too much commitment.

The wedding is a special occasion. It opens the door to a new and special journey. But our society is sitting on the crux of change. As families and as a country, can we afford such extravagance? Without over-spending and showing off, one can still have a fun, festive, joyous wedding. The money one saves can help so many others. If no one else, it can help the couple settle in life.

Time to re-think weddings.

http://tns.thenews.com.pk/millenials-us/#.XKW3p5gzbIU

King of Sweets – Gulab Jamun is now Pakistan’s National Sweet

A perfect gulab jamun, not hard at the core, not mushy and soft to break down, is now Pakistan’s national sweet

King of sweets
In the midst of macabre headline news, Pakistan’s favourite comfort food made it big. The nayi government of naya Pakistan ran a poll on Twitter as the naya saal (New Year) ushered in: “Which should be the National Sweet of Pakistan?” There were three options: jalebi, gulab jamun, and barfi. More than 15,000 people voted, and gulab jamun won with 47 percent votes.

The poll I subsequently run on my facebook page had just two options: gulab jamun contended only by barfi. Gulab jamun won by a whopping 79 percent votes.

However, are polls on social media enough to decipher what is Pakistan’s favourite indulgence when it comes to a sweet tooth? There has been an uproar among social media users who complain that there was no national consultation in this important existential debate. However, at grassroots level, gulab jamun does seem to have tugged at the nation’s heartstrings. Mithai sellers and caterers confirm that gulab jamun is indeed the hottest selling item [pun intended] as they taste best when warm, bordering on hot.

The historical origins of gullus, as gulab jamuns are often fondly called, are often traced back to the times of Mughal emperors, particularly Shah Jahan. Folklore has it that Shah Jahan’s royal chef accidentally fused elements and by a stroke of fate, a sweet from heaven found its way on earth. Other food historians claim that its origins are Turkish or Persian. As diverse as the language in which its name is taken, which is Urdu, gulab jamun seems to be wrapped in layers of culture and history. Whatever its trajectory may have been, it is part of the very essence of happiness in the subcontinent.

Gulab jamuns are like all good thing in life. It has to be just right, and one mistake can be unforgiving. A perfect gulab jamun requires technique, skill, precision, accuracy, and above all patience. They cannot afford to be hard at the core, but also cannot be so mushy and soft that they break down — just like a well-rounded person [pun again intended]. The reduced milk — khoya — which forms the basic ingredient of the dough of the tempting dessert, is derived after painstakingly cooking milk till it evaporates, leaving behind khoya. Once these dough balls are fried and are light brown, or blackish if it is a kala jamun, they are then soaked in sugar syrup. The syrup was originally rose-flavoured, which gives it the suffix “gulab”.

Now, the rose essence is optional. But the sugar syrup or “sheera” as we Pakistanis lovingly call it, is a must. As an avid gulab jamun fan said when asked why she loves, “the sheera drips into my soul… it makes everything seem alright”. Warm it a bit and it melts in the mouth. Put it in zarda (sweet saffron rice) and a bite with tiny gulab jamun makes you thank God for the good life. Have it after dinner or compliment it with chai. Gulab jamuns allure you. It is perhaps these enchanting qualities of the gulab jamun that make it the popular choice.

As a barfi lover, it is not easy for me to accept the supremacy of this King of Mithai. But one has to accept that gulab jamun has a more comforting and satisfying feel to it.

Gulab jamun being crowned as Pakistan’s national sweet has led to debates across borders. Nations across the subcontinent — India, Nepal, Bangladesh, and of course Pakistan — are claiming that it belongs to them. The debates on social media are often divisive. Everyone wants to establish that the home of the gulab jamun is their country. The gulab jamun smiles on, basking in its golden glory, while its lovers’ squabble like the “raqeeb” (adversary) in Urdu love poetry of yore would fight for a claim to the beloved.

Fact remains that Pakistan has taken the lead and gulab jamun is now, officially or semi-officially, Pakistan’s national sweet. But looking at the glass half full, here’s what is great about this phenomenon: If in nothing else, Pakistan and India may find themselves on the same page, for once, when it comes to the love of gulab jamun. When all else may have failed to build bridges, this gastronomic delight may do the trick. How sweet!

http://tns.thenews.com.pk/king-sweets/#.XDxKp7hS81k

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.

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