Fair, Lovely and Politically Incorrect

By: Fozia Tahir

Having lived in the UK for five years I had almost forgotten the importance of fair skin in Pakistan. I recently attended a musical event in my hometown in the north of Pakistan where majority of the population has lighter skin tone. The Host who of course happened to be from the south said, ‘the crowd was full of goray chittay people literally meaning, ‘fair skinned (beautiful) people’. The crowd is so used to such comments that no eyebrows were raised and no offence was taken. In the west however, the same host would have had to apologise soon after giving such a statement.

Why did no one question it?

Why were those who are not as fair skinned as most not offended?

Where exactly does this mind-set come from?

and why must we make peace with it?

We have been blaming colonialism and American influence on Pakistan for so many things but perhaps our mind-set is our own problem. Many politically incorrect things, including the obsession with fair skin, seems to have percolated deep down our thought process. I will not quote many research articles and figures here today but blame our media industry and the people involved in it for continuously reinforcing all the false ideas and poor mind-set that we have long fallen prey to.

Those who know Pakistan well would also know that television is the biggest form of entertainment for majority of the population residing in the urban as well as rural areas of Pakistan. People love to spend their afternoons and evenings in front of their TV. I wanted to see what was going on, on TV in terms of obsession with fair skin. I realised soon after that almost all the skin care products sell the very concept of getting lighter skin tone. Such as, 

Urdu: Hum larkiyon ka face fresh hona chahiye

Translation: Us, girls should have a fresh face

You shouldn’t second guess the name of the product. It is indeed called face fresh

Fair and lovely has long used women with dark skin tone as their models and shown their skin tone improve with the use of their product over time as an example.  This is 21st century and I think it’s about time that fair and lovely changes the name for the new lines it is creating.

What’s funnier is that some of these creams don’t display the products that they contain. E.g. I looked at the packaging of a famous whitening cream called gypsy amazing cream that only said at the front that it contains jojoba oil but no further ingredients were given at the back. It is obvious that the products contain bleach and few major ingredients should be placed at the back of the packing. Its not really my problem as I wouldn’t use the product unless I am conducting some kind of research experiment on the product but those who use it deserve to know what must the mystery magic box contain.  

Fair is not good and kaala (dark skin) is not bad and we need to break such stereotypes especially popular products like Fair and lovely whose consumers seem unaffected by such form of political incorrectness.  

The root of all our problems could be lack of education but many formally educated people also believe in the importance of fair skin. In fact, in Pakistan, fair skin is a requirement in the proposal checklist for a girl from the male side.

Women invest more time and money on their physical appearances and almost no time on personality growth..

Solution: Change aka Tabdeeli?

Change is coming. The newer generation is ready to fight all the stereotypes but we are still shackled by many concepts the like of fair is beautiful.

we have a long long long way to go until we speak about issues like pay gap and equal pay for equal work etc nevertheless we should not give up on our fights to break stereotypes.

Good Luck to us for that…

 

 

 

 

 

 

Image link: https://www.flickr.com/photos/66542607@N07/6266540192

Violence against women and girls

 

An eighteen-year-old woman chronically raped by her father, brother and uncles since she was eight.
A nineteen-year-old girl having chronic pelvic and genital pain secondary to genital mutilation.
A twelve-year-old female child being sold and married off to a forty two year old man in her village.
A twenty-eight-year old woman physically beaten by her husband regularly when he is intoxicated.
A forty–ear old woman who was kidnapped and sold to her former husband when she was nineteen.

These are just examples of women and female children whom I have come into contact with through my clinical practice, outreach work and in my social life. I have found these women in the emergency rooms, in psychiatric facilities, in the genitourinary medicine & contraception clinics. I have found these women not only as a doctor in the corridors of hospitals – I have found these women in the lanes of my life.

All of these women, as you may have guessed by now, have been subject to violence. Violence against women takes place in several forms – physical violence by intimate partners, sexual harassment, sexual violence, female genital mutilation, trafficking, child marriages etc.

Although there is an increased awareness of the violence suffered by women and female children, we still live in a society where violence is horrifically rampant. We live in a world where a third of the countries have NOT outlawed domestic violence. We live in a world where 1 in 7 girls are married in Central and West Africa before they are 15 years of age. We live in a world where 1 in 2 women were killed by their partners and/or families in 2012. We live in a country where up to a third of adolescent women describe their first sexual experience as rape/sexual abuse. We live in a world where thirty-seven countries exempt rape perpetrators from prosecution if they are married or marry the victim after the event1.

The purpose of this article is to educate and discuss the nature of violence experienced by women, to understand the extent of the problem, and finally, what to expect from our health professionals and our governments.

The vast majority of the statistics and information is taken from the World Health Organisation and the United Nations websites, which I implore you to read. All of the factual information, which is present in this article, from the aforementioned institutions is listed at the end.

Background and definitions

Violence against women is a global public health problem and a violation of human rights. The United Nations defines violence against women as “any act of gender-based violence that results in, or is likely to result in, physical, sexual, or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life2 .

A 2013 analysis conduct by WHO with the London School of Hygiene and Tropical Medicine and the South Africa Medical Research Council, used existing data from over 80 countries and found that worldwide, 1 in 3 women have experienced physical and/or sexual violence by an intimate partner or non-partner sexual violence3.

Risk factors4

The risk factors for women experiencing intimate partner violence include low education, exposure to mothers being abused, abuse during childhood, attitudes accepting violence, male privilege and women’s subordinate status.

Equally, men are more likely to perpetrate violence if they have low education, a history of child maltreatments, exposure to domestic violence against their mothers, alcohol dependence, unequal gender norms, attitudes accepting violence and privilege over women.

Factors associated with sexual violence perpetration include beliefs in family honour, sexual purity, ideologies of male sexual entitlement and weak legal sanctions for sexual violence.

Impacts on health, children and socioeconomics

Physical and sexual violence against women has led to physical, mental, reproductive and sexual health issues of victims. Some of these include unwanted pregnancies, sexually transmitted infections and other gynaecological problems. Specifically, in pregnancies, the risks include miscarriage, pre-term labour and the babies being at significant risks related to low birth weight.

Women exposed to partner violence as twice as likely to experience depression; almost twice as likely to have alcohol use disorders; 1.5 times more likely to acquire HIV, syphilis, chlamydia or gonorrhoea and 16% more likely to have a low birth weight baby. Furthermore, 42% of women who have experienced physical/sexual violence at the hands of a partner have experienced further injuries as a result and 38% of all murders of women, globally, were committed by their intimate partners1,3.

Children who witness such violence can display behavioural and emotional disturbances as well as being at risk of being perpetrators of violence themselves. Intimate partner violence has also been linked with higher rates of infant and child morbidity and mortality3.

The social and economic costs include women being at risk of suffering isolation, not being able to work, losing wages, not participating in regular activities and being unable to care for their children.

Prevention and response5

There are a number of guidelines as to how health professionals can train, prepare and respond for issues in violence against women. These include:

  1. Providing women centred care – professionals offering first-line support when violence is disclosed i.e. empathy, non-judgemental attitude, privacy, confidentiality and access to relevant services.
  2. Identifying and caring for survivors of intimate partner violence – Professionals should ask about exposure to violence with the aim to improve diagnosis, identification and subsequent care. First line clinical care should include emergency contraception, STI and HIV with relevant follow up.
  3. Mandatory reporting of intimate partner violence to the police is NOT recommended. Professionals should offer support to report the incident if the woman chooses. It is important to know the legal framework of reporting in each state/country. Usually if an incident is to be reported, the professionals should NOT carry out an intimate examination.
  4. Training of healthcare providers – Adequate history taking, risk management, investigations and planning management should be done at a pre-qualification level.
  5. Healthcare policy and provision – Care for women experience violence and sexual assault should be, where possible, integrated into existing health services as opposed to a stand alone service. In the UK, this can include presenting to a General Practice, GUM services and if required, A&E.

Prevention is a powerful tool and evidence base from high-income countries has suggested that advocacy and counselling improve access to services for victims and are effective in reducing violence. In low resource countries, prevention strategies that have shown some effectivity include programs that empower women economically and socially through a combination of microfinance and skills training related to gender equality; that promote communication and relationship skills within couples and communities; transform harmful gender and social norms through education6.

Legislation is another key aspect, which can help achieve change. There is a need to implement policies that promote gender equality by ending discrimination against women in marriage, divorce and custody laws; ending discrimination in inheritance laws; improving women’s access to employment and developing national policies to address violence against women5,6.

References and further reading

1. United Nations. Declaration on the elimination of violence against women. New York : UN, 1993.

2. United Nations. Fact and figures: Ending violence against women. http://www.unwomen.org/en/what-we-do/ending-violence-against-women/facts-and-figures

3. World Health Organisation. Global and regional estimates of violence against women. Prevalence and health effects of intimate partner violence and non-partner sexual violence. http://www.who.int/reproductivehealth/publications/violence/9789241564625/en/

4. World Health Organisation. Violence against women and children: facts. http://www.who.int/news-room/fact-sheets/detail/violence-against-women

5. World Health Organisation. Primary prevention of intimate-partner violence and sexual violence: Background paper for WHO expert meeting May 2–3, 2007
6. World Health Organisation. Infographics: Violence against women infographic. http://www.who.int/reproductivehealth/publications/violence/VAW_infographic.pdf

Written by: Dr Huma R Khan

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Glacial ice- what is the future?

Part 1

Author and Narrator : Fozia Tahir

 

Background Information 

Fresh water accounts for only 3% of global water resources. Remaining 97% is sea water that contains salt and is unfit for drinking and agriculture. Out of the 3% freshwater available 2.5% is in frozen form in glaciers and arctic ice. Most of this water is stored in aquifers, followed by rainfall falling, natural lakes, man-made storage facilities and rivers. Even this little water that is available for human consumption is not evenly distributed around the world.

Water is essential for life on the planet. It seems to be the only divide between poverty and prosperity. It’s essential for life on the planet (agriculture, food, energy and manufacturing etc) and defines the ecosystem. The limited fresh water supply is getting impacted by rise in population and climate change. Water demands are increasing while the supplies shrink. This requires communities to adapt to the changes. However, there is a need for all of us to mitigate alongside adapting to the global environmental changes. As the water stress and scarcity increases in some areas, increased runoff and rise in sea level will take place in others. Today’s article will focus on one of the largest fresh water resources on the planet i.e. glaciers (and arctic ice).

Case Study

A study in Australia predicted that areas of Antarctica that are permanently without ice could increase by up to 25 per cent by the end of the century because of climate change. About 68,000 square kilometres (less than 1%) of the white continent is currently ice free, and that land is home to 99 per cent of Antarctica’s terrestrial plants and animals, including penguins, seals and seabirds and unique species of mosses, lichens, fungi and small invertebrates. According to Aleks Terauds, a lead researcher with the Australian Antarctic Division, expansion of ice-free areas could have serious implications for biodiversity because of increased homogenisation. The biodiversity of Antarctica is unique, vulnerable, different to anywhere else in the world, and so well protected but we have to manage their conservation and protection with climate change. We must join scientist in efforts to reduce carbon emissions around the world as the rise in sea level will also strip many island communities of their homes.

Climate change is a threat because species have evolved to live within certain temperature ranges, and when these are exceeded and a species cannot adapt to the new temperatures, or when the other species it depends on to live cannot adapt (its food supply), its survival is threatened. All changes we have seen to date has been for a temperature rise of less than 1% since the late 19thCentury. The international panel on climate change (IPCC) has predicted a rise of an average 6 degrees Celsius or more by 2100 based on the current trends in burning fossil fuel.  

Glacial Ice and Glaciers:

Glacial ice (glaciers, ice caps and ice sheets) covers nearly 10% land area on earth and accounts for 75% of the global freshwater.  World glacier inventory (WGI) provides information for over 100,000 glaciers throughout the world. Glaciers form where snow is deposited during the cold and does not entirely melt during warm periods. This seasonal snow gradually densifies and transforms into perennial firn and then the interconnecting passages between the grains are closed off into ice. This mass of surface-ice on land which flows downhill under gravity and is constrained by internal stress and friction at the base and sides. In general, a glacier is formed and maintained by accumulation of snow at high altitudes, balanced by melting at low altitudes or discharge into lakes or the sea. Glacial surges (i.e. advances due to sudden flow with velocities up to 100 times faster than normal advances) and glacial retreats are natural events but their scale is increasing with climate change. Changes in atmospheric conditions influence the mass and energy balance at the glacier surface. In fact, the very concept of climate change has long been spread, showing calving or break off and fall of glacier ice into the water.

Lake formation and glacial lake outburst flood

Lakes can be formed underneath (subglacial), within (englacial), on the top (supraglacial) of or in front (proglacial) of a glacier. The lake formation can be permanent, periodic or infrequent, controlled by the changes in the glacial drainage system. The change can be slow or catastrophic after a threshold. Earthquakes, subglacial volcanic eruption, rock avalanches or debris flows reaching lake can also cause sudden GLOF. Lake formation and glacier retreat usually happen in parallel. As the glaciers retreat, they also deflate and more crevices open. Some of these outbursts endanger human life and resources.

 

Pakistan

With 7,253 known glaciers, including 543 in the Chitral Valley, there is more glacial ice in Pakistan than anywhere on Earth outside the polar regions, according to various studies. Those glaciers feed rivers that account for about 75 percent of the stored-water supply in the country of at least 180 million. But like the other parts of the world, the glaciers are receding, especially those at lower elevations in the KPK. Factors such as overpopulation, poverty complicate the glacial receding e.g. scooping of the ice in warm weathers by people who make money out of it. Data gathered by the met office over the last 50 years shows that around 120 of the glaciers are showing signs of melting.

Other researches recommend that in Gilgit Baltistan due to higher precipitation the glaciers may expand. Many glaciers are covered with silt and debris that insulate them. One such research was carried out in the Shimshal valleyof Pakistan to investigate why while glaciers in the other parts of the world are shrinking, many Karakoram glaciers are advancing. The effect is known as Karakoram anomaly. I will be speaking to the researcher in my next podcast about his research.

Until we come back with the next section of this podcast I want you think about 

What should be done?

  • Does the state implement any laws on ownership and use of glacial ice?
  • Are local communities aware of sustainable use of natural resources?
  • How has change in glacial ice impacted local wildlife?
  • What should be next?
  • Do we have quality local and national level research going on?
  • Do the studies involve GPS and other satellite tools to understand the change and the rate at which change is happening?
  • What will be the effect of China Pakistan Economic Corridor (CPEC) on the already melting glaciers?

 

 

 

Reference:

 

  1. “Water for People, Water for Life” UnitedNations World Water Development Report, Part II: A look at the world’s freshwater resources. UNESCO, 2003,
    unesco.org
  2. https://19january2017snapshot.epa.gov/climate-impacts/climate-impacts-water-resources_.html(27th April 18)
  3. https://nsidc.org/cryosphere/glaciers/quickfacts.html(26th April 18)
  4. http://www.grid.unep.ch/glaciers/pdfs/glaciers.pdf
  5. https://www.washingtonpost.com/world/asia_pacific/pakistan-has-more-glaciers-than-almost-anywhere-on-earth-but-they-are-at-risk/2016/08/11/7a6b4cd4-4882-11e6-8dac-0c6e4accc5b1_story.html?noredirect=on&utm_term=.123bc0511720
  6. https://www.reuters.com/article/us-pakistan-glaciers-highway/pakistans-glaciers-face-new-threat-highways-black-carbon-idUSKBN1D30WK
  7. http://www.abc.net.au/news/2017-06-29/biodiversity-antarctica-climate-change-increases-ice-free-areas/8662054
  8. https://chge.hsph.harvard.edu/climate-change-and-biodiversity-loss

 

 April 2018: Photo showing rescue operation in progress past a rock and ice avalanche in Ultar Hunza (source: Pamir times)190769_32934_updates

 

 

Sexuality and Physical Education at Home and School

Written and Narrated by: Fozia Tahir

According to UNESCO (2009), the primary goal of sexuality education is to equip children and young people with the knowledge, skills and values to make responsible choices about their sexual and social relationships in a world affected by HIV. In addition to learning about the risks of pregnancy and sexually transmitted infections (including HIV), children and young people also need to learn about the risk of sexual exploitation and abuse to recognise these when they occur, to protect themselves as far as possible and to identify and access available sources of support. Sensitising children, parents, teachers, police and local communities to the nature and extent of sexual violence, and giving permission to discuss it, are essential steps in tackling it. Sexuality education can provide an appropriate framework and context for educating students about sexual abuse.

This process of gaining knowledge about sexuality can come from both formal and informal sources focusing on the core set facts about sexuality. What should be included in the formal sex education is yet another area that needs more research and discussion.

Values permeate the whole process of sex education. But one must still question why should there be a discussion on this?

  • Because the diversity that exists in contemporary society makes a consensus on value impossible
  • Because some of the aims of sex education such as reduction in number of child abuse cases, teenage pregnancies, exposure to diseases etc, are of much importance to all societies
  • Because it can help individuals develop a non-judgmental approach towards diversity in society (not however towards rape and sexual abuse)

The process of value development begins at earliest childhood and goes throughout life and schools have a distinct role to play in this value system, including

  • Reflect the values of the society
  • To fill in the gaps in student knowledge and understanding including the knowledge of importance of values
  • Encourage pupils to choose a rational path through the variety of influence that can impinge on their experience e.g. they need help to make sense of diversity of sexual values which they have picked up from variety of sources and to be critically reflective

All of this however requires for the teachers to be critically reflective themselves.

There is a lack of consensus on sexual values, with religion being the major influence. Over the time however, sexuality has become more visible and much more widely accepted. When it comes to global sexuality education programs most often three approaches are observed

  1. The right based approach
  2. The morality approach
  3. The health approach

Schools are very often given freedom in sexuality education curricula.

  1. Right based approach (RBA):

This approach is based on human rights i.e. entitlements that belong to individuals despite their gender, race, religious orientation, ethnicity or socio-economic status. It is up to governments on how to proceed with these rights. RBA combines human rights, development and social activism to promote justice, equality and freedom. It also ensures gender sensitive and sex positive education for young people to be more empowered. Sexuality education can also address social inequality and exclusion.

  1. Morality based approach:

The idea of morality-based approach is to make children honest, responsible, compassionate and virtuous i.e. to turn students into mature adults. Sexuality education is tied to sexual morality and religion. Moral values are quite a sensitive issue e.g. presenting the idea of pre-marital sex in many religious countries.

  1. Health based approach:

Education that relates to unwanted pregnancies and sexually transmitted diseases, rather than concentrating on sex prevention strategies. This approach allows individuals to face the facts and understand health challenges and outcomes of unsafe sex.

  1. Abstinence until marriage:

The main opposing approach to sexuality education is abstinence only. Not only does it encourage abstinence of sex until marriage but also avoids discussion on use of contraceptives and disease prevention.

In terms of practice and application in schools, Morality based approach seems to be the preferred type.

But how does individual make these choices?

Decision theory explains the factors that go into each decision that a person makes. Decisions may happen in a split second or over a matter of minutes, days, or years. When faced with several decisions, a person considers the benefits and risks of each choice. They make a comparison and decide that one choice is worth a substantial risk because of its substantial benefits. Weighing the benefits and risks of sexual activity is usually a longer and more complicated process. The sex education debate is much about decision theory. What information will enable young people to view risk and benefit in ways that will lead them to make good sexual decisions.

Sex and sex education although being ageless are a taboo topic in conservative societies like ours. It is true that even educated people like myself will not appreciate too much information for children at a younger age. But if one thinks about it closely there is a floodgate of information available online and It is perhaps better for students to learn basic physical and health education in schools.

Whether this education should come from homes or schools is still arguable, I personally think it has to come from both.

United Kingdom

Sex education in school

Sex and Relationships Education (SRE) is taught as part of Personal, Social and Health Education (PSHE) under the National Curriculum in the UK.

SRE aims to:

  • recognise the importance of marriage and stable relationships in family life and raising children
  • provide information appropriate to each age group
  • involve parents as much as possible in their child’s sex education
  • reduce the number of teenage pregnancies and sexually transmitted infections (STIs)

Initially, parents had the right to withdraw their child from SRE classes up until the age of 19. But it has now become compulsory for children aged 15-16.

What will a child learn in sex education class in the UK

Children are taught about different aspects of sex at different ages, summarised in the following table

Age Guide to what is taught
ages 5-7 puberty, relationships and how to be safe
ages 7-11 puberty, relationships (including marriage, divorce, separation, same-sex and civil partnerships), managing emotions and dealing with negative pressures
ages 11-14 sexual activity, human reproduction, contraception, pregnancy, sexually transmitted infections, relationships
ages 14-16 body image and health, choices about sex, parenting skills and family life, separation and divorce

Faith schools are encouraged to devise SRE classes that reflect their faith’s values and ethical codes.

Sex education at home

Role of a parents in child’s education about sex and relationships is important. The teaching of these subjects in school is designed to complement the discussions parents have with a child at home.

Before discussion, parents should

  • Think about their own views on sex and what matters to them in relationships and family life.
  • Work out their own values and morals so that the children get clear, consistent messages about sex and relationships throughout childhood.

Sex education is most effective when it’s built up gradually over a number of years, so ignoring the subject will not help the children. Its helpful for a child to grow up with clarity about sex and relationships.

Tips for parents on talking to a child about sex and relationships:

  • Try to make discussion of sex a part of normal life not just a one-off talk (according to your norms and values).
  • Talk as naturally as possible to your child as this will encourage him or her to be more relaxed and open with you.
  • Answer any questions your child asks as clearly as you can so that he or she doesn’t become confused.
  • Listen carefully to what your child has to say and try to deal with any fears, concerns or misunderstandings as they arise.
  • Be truthful if you don’t know the answer to a question – try to find out the answer and then raise the topic again another day.
  • Don’t avoid a topic if you feel uncomfortable or embarrassed about raising it. Consider introducing the subject via discussion of a TV programme or magazine article or what your child is learning in class.
  • Make sure any discussions are appropriate to the age of your child

 

Challenges of Sexuality Education

  1. Influence of parents on the education of their children
  2. Teaching social skills relevant to sexual behaviour in classroom settings requires special expertise in both design and delivery of the content

 

Pros of sex education:

A sexually educated person besides being educated and informed

  • Will have certain personal qualities e.g. self-assertion, personal security, and fairness etc
  • Will have certain attitude e.g. such as views on abortion, divorce, or homosexuality
  • Will have certain skill e.g. responsible decision making

So, I would like to conclude that with the amount of information available online and offline and rising occurrences of cases of child sexual abuse and sexual harassment, bans on abortion its becoming more and more important for proper research and debate in this field and for it to be taught from formal forms of education and therefore schools and education systems have a huge role to play in it.

References:

  • Magoon, Kekla. Sex Education in Schools. Edina Minnesota: ABDO Publishing, 2010
  • Bella, V. L. 2014. Incorporating Sexuality Education in the Public-School System: Perceptions from the Philippines. University of Amsterdam, MSc International development studies, Amsterdam.
  • http://www.bbc.co.uk/schools/parents/sex_education_support/ (30-1-2018)
  • Halstead, J. M. & Reiss, M. J. 2003. Values in sex education: from principles to practice. RoutledgerFalmer, London
  • 2009. International technical guidance on sexuality education. Paris: Unesco. Online at http://data.unaids.org/pub/ ExternalDocument/2009/20091210_international_guidance_sexuality_education_vol_2_en.pdf

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