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The Legal Trauma of Rape

On February 25, 2012 By Farieha Aziz In 16 days, Blog, Gender, VAW

This article was originally published in Newsline’s March 2010 as a box in article Fight to the Finish

Each year, WAR targets to take 20 cases of rape to court. This number never exceeds 15, and even fewer get justice. Since the merit of the case is determined by the charge that is framed, the testimony of witnesses and the medical report, discrepancies in the system contribute in a large way to unending trials and unfavourable verdicts.

“Every law has three different components,” says Sarah Zaman, WAR project coordinator. “One is the substance, which is the actual written law, then is your structure, the people who are actually enforcing the law like the police, lawyers and judges, and then there is your culture. When you talk about equity and justice, it is based on all three of these. They need to work simultaneously to have an impact.”

Thus, even if corrective measures are introduced to the substance (law), if the structure is left unaltered, then the procedural discrepancies render the law ineffective. “There are a lot of grey areas in cases of rape and unless your judges and lawyers have a very good grasp and understanding of the issue and the subtleties of trying a rape case, they will not be able to give very informed decisions,” says Sarah. “You also need lawyers or prosecutors who know enough about the issue to be able to present the case in a convincing manner and actually get a favourable verdict.”

Whether it is the lack of awareness or a lack of will, or both, the very people who should facilitate justice end up obstructing it. The framing of the charge is essential to the trial of a case, says WAR lawyer Farida Moten, “If the FIR and charge is registered under the Hudood Ordinance, then the case goes to the Shariah Court. If it is registered under the Pakistan Penal Code [PPC] then it is tried in the trial court.” For survivors to benefit from the distinction between rape and zina, the charge has to be registered under the PPC.

The Women’s Protection Bill 2006 had come into effect when Naseema Lubano registered her case in January 2007. Despite that, the police registered her case under the Hudood Ordinance instead of the PPC.

There are also situations in which the police refuse to register an FIR altogether. In such a case, WAR personnel accompany the survivor to the police station and speak to the relevant officer or to a higher-up. However, if they still do not cooperate, then the organisation holds press conferences or issues press releases and statements mentioning the particular police station that is not cooperating.

“The police don’t understand that their job is to register a case, to investigate it and to present their findings to the court. Everybody at their own level plays judge,” says Sarah.

Unless the survivor is physically present, an FIR cannot be registered. It is not easy or always possible for survivors to come forward due to a number of factors, and the fear of the police and court culture, which passes judgments on a survivor’s personality, her character, her history and her sexual history, also keeps them away. The law does not take into account the intimidating environment a psychologically disturbed survivor is placed in. Allowing someone to register an FIR on behalf of the survivor should be permitted, as is the case in other countries, says Sarah.

The medico-legal report, which sets the very basis of a case, states only whether a woman is ‘sexually habituated’ or not. Scars, burns, or other marks of torture or physical abuse are not reported. Finger testing is the only method applied, which checks the elasticity of the vagina and the presence of the hymen. “This method reveals nothing about the act or the crime that was committed. And if the survivor is a married woman, she obviously is sexually habituated; what then constitutes medical evidence?” Sarah asks.

That evidence can be collected from places such as under the nails, behind the ears, or that a woman’s belly can be checked for traces of semen, is not known to medico-legal practitioners, neither are they equipped to collect such samples.

Often, women remove vital evidence out of shame and guilt: they wash their clothes or take multiple baths, removing possible traces of semen.

Also, a lot of survivors and their families seek out-of-court settlements because getting one lakh of rupees is a far better deal than doing the rounds of court for three years and becoming social outcasts. Time caps for rape cases, be it for the registration of a challan by an investigation officer to the report of a medico-legal examiner to the actual case itself, need to be put in place.

Let us break the silence!

On February 23, 2012 By Jehan Ara In Blog, Gender

As we stood at “Do Talwar” with our banners and placards raising our voices against irresponsible statements from politicians, insensitive and unethical reporting by media and increased unchecked incidents of violence against women in the city, it was strange to see people passing by in their cars or on foot, turning around to look at us as if we were the weird ones. There was a bevy of media people gathered around us, most of them trying to understand what the fuss was all about, many of them probably on the lookout for a politician or two. They spotted a couple of celebrities amongst the protesters and headed for them and when one of the policemen decided to make a statement, the focus of the media switched to him instead of to the protest itself.

One of the television guys actually tried to get all the women in one place so that he could film just us. I asked him why he wanted just the women. There were a lot of men there too. He said “because this is a woman’s issue.” How is violence a women’s issue? How is crime a women’s issue? How is a protest against irresponsible reporting a women’s issue? How is totally senseless statements that are aimed at the survivor as opposed to the perpetrator a women’s issue? How is revealing the name, car registration number and other details of the survivor a women’s issue?

When will people begin to understand that any issue that affects any citizen of this country, actually affects us all and all of us need to raise our voice against injustice, against violence, against corruption, against inadequate health and social services, against insufficient funds spent on education, against unethical and irresponsible behaviour. If we don’t, then we have only ourselves to blame.

With the increased number of media channels, magazines, newspapers, FM stations and social media networks out there, it is extremely important that we become more responsible in whatever we say and write. I am not suggesting unnecessary legislation or censorship. However, we need to understand that with Freedom of expression comes great responsibility. We must ensure that whatever we say is accurate, is corroborated, does not infringe on someone’s privacy and is not insensitive or unethical or likely to cause harm. We also need to do some research on the subject we decide to write or talk about.

Many of the tv channels had only sent cameramen to the protest and even those reporters who were there, were unaware of the issues so how could they possibly create a credible report. A few of the Print media had sent people who asked some sensible questions. However, I was very disappointed to see that when WAR’s (War Against Rape) Khadija started to talk about all the pending cases that needed attention, no-one from the press actually listened. It was very sad.

We look to the media to be watchdogs, to report the news responsibly, ethically and intelligently so that there is accountability. But with Breaking News being the order of the day, who checks facts, who bothers to be sensitive to the victims needs, who cares if the survivor’s privacy is protected. Sensationalism and sound bytes is what it’s all about.

This was the first time that the “Take Back the Tech” team participated in a street protest. We were proud to be there with our placards asking for an end to violence. Other protesters were curious but happy to see us there. They asked us what the Take Back the Tech campaign was all about and, once they knew, many of them held up the extra placards we had taken with us. If nothing else, we were able to create an awareness, speak up against injustice and show our support for the cause. I was also happy to see some colleagues from Microsoft at the protest. It was actually quite a diverse group. Amongst them were artists, writers, finance people, housewives, teachers, business executives, NGO representatives, students and activists.

Maybe people are finally realizing that it is time to wake up. We are citizens of this country and if we want things to change, we need to speak up for ourselves and for others. Let’s break the silence now. Let us hold people accountable. Let’s join hands and offer solutions, not just criticism.

Pakistan’s Suffragettes

On February 19, 2012 By Farieha Aziz In Blog, Gender, VAW

This article was originally published in Newsline’s March 2011 issue

“There are already so many laws; why do we need new ones?” was one female politician’s response to enacting women-related legislation in the country. In January this year, in what was termed an ‘honour’ killing, a 21-year-old girl was electrocuted by her family because she wanted to marry of her own choice. So would murder charges alone be fitting for a crime of this nature? In any civilised state, the answer would be a resounding ‘no.’ But in the murky waters that are Pakistan’s legal canons, there are no absolute answers.

After a decades-long struggle for the rights of women, laws finally began to be enacted in the new millennium to reclaim the rights they had lost under the Hudood Ordinance. In 2004, some headway was made in this regard in the form of the Criminal Law (Amendment) Act, when the Criminal Procedure Code (CrPC) was amended to include ‘honour’ killings as a crime. But as evinced by events, often amendments are not enough. Even though the Criminal (Amendment) Act 2004 on ‘honour’ killings exists, it remains virtually ineffective. And given the ongoing and ever-increasing murders of this ilk, legislation criminalising killing in the name of ‘honour’ is imperative.

Similarly, while the amendments introduced to the CPrC through the efforts of Justice Fakhr-un-Nisa, Marvi Memon and Anoushey Rehman to criminalise acid attacks was a step in the right direction, they addressed only the crime. However, says Valerie Khan of the Acid Survivors Foundation (ASF), the legislation that has been drafted now goes beyond both the crime and punishment. “Burn care is extremely expensive,” she says, and so in addition to the punishment for the offence and a fine, the Bill includes making the perpetrator cover the expenses of treatment and rehabilitation of a victim.

The question is, in a country with corrupt law enforcers and a questionable justice system, how often are laws implemented – and how wide is their ambit? Says rights activist and professor, Dr Farzana Bari, “Laws do not mean the issues will go away, but at least one is forced to take notice of them.” Common wisdom holds that, at the very least, the existence of a law will act as a deterrent. Hina Jillani, a Supreme Court advocate, maintains that laws are an instrument of social change and even if inadequate, they should be used. “A law has a role if it is used. Its usage allows it to be developed through the courts, so it must be used as frequently as possible,” she says, citing the example of the Women’s Protection Act (WPA) 2006, which in her view is not complete reform, but is a step forward.

Studies reveal that the WPA brought substantive relief to women. Since its enactment, not a single woman has been charged with zina or made to languish in jail, as was the case prior to the law. Additionally, post the Act, several rape cases were reported and tried in court, and even though cases that were taken up by the media, like those of Mukhtaran Mai, Kainat Soomro and Naseema Lubano, are still ongoing, with the survivors awaiting justice, at least there is a glimmer of hope regarding the outcome. Furthermore, there are other instances where justice has actually been served. A case War Against Rape (WAR) Karachi was pursuing since December 2007, where a man raped his uncle’s wife, was concluded in December 2010 with the rapist sentenced to 10 years rigorous imprisonment and a fine of Rs 10,000. On an even faster track was another case: the attempted rape of a six-year-old girl that was reported in 2009 and was concluded in December 2010 with a sessions court sentencing the accused to 10 years rigorous imprisonment and a fine of Rs 50,000.

However, for all the good the law has done, it now lies in jeopardy. The Federal Shariat Court (FSC) verdict hangs over women’s heads like the proverbial sword of Damocles. The FSC, on December 22, 2010, declared that Sections 11, 25, 28 and 29 of the WPA were unconstitutional. It has directed the government to amend the laws and bring them in “conformity with the Quran,” and failure to do so by June 22, 2011, will make the cases that currently fall under these sections revert to the Hudood laws.

This would strike a devastating blow to the substantial progress that was made over the past few years. The government and other organisations have the right to file an appeal, and although, according to Dr Bari, it is the government that should go into appeal since it is the writ of the parliament that has been challenged, the government continues to procrastinate. However, Jillani, on behalf of the Women’s Action Forum (WAF), the Human Rights Commission Pakistan (HRCP) and Aurat Foundation has filed an appeal. This will, at least, prevent the verdict from becoming the law unchallenged.

The attempt to render women-related laws ineffective seems to have been part of a sustained campaign in Pakistan. The major grouse with the amendment for ‘honour’ killings is that while karo-kari, etc., are recognised as crimes under the Pakistan Penal Code (PPC), and are punishable, the offence is a compoundable one – i.e. in most cases, the family of a karo-kari victim is responsible for the killing, yet it is with them that the power to waive the punishment resides, rendering the law ineffectual.

Efforts are also currently underway to render the Domestic Violence Bill (DVB) ineffectual. The DVB seeks to provide protection to women and children who suffer domestic abuse in their homes at the hands of relatives/in-laws. If this legislation comes into effect, a woman whose husband has beaten her up cannot be told by a policeman: “Jaien bibi ghar jaien, yeh aap ke ghar ka muamlah hai” (Go home and deal with it, this is your personal problem). Instead, the husband can be prosecuted under law. However, an addition in the form of a clause “penalty for filing a false complaint” has been made to the DVB, which did not exist in the original draft of the document. This was also proposed for the Protection Against [Sexual] Harassment Act 2010 when it was under discussion, but fierce resistance managed to get the bill converted into law without the insertion of the clause.

The main concern and objections expressed with regards to both bills were of their possible misuse. Ironically, the same concern is glaringly absent vis-à-vis the Blasphemy Law, which has repeatedly been misused and caused the loss of several lives. Yet, it seems to be a major determining factor for a law that hasn’t even seen the light of day yet, and that certainly does not carry the death penalty. While the matter remains unresolved, jurists and activists alike surmise that what the insertion of this clause would do is deter a victim from coming forward, reporting the crime and seeking justice – which is the whole point of the legislation.

What is even more ironic than the concern about misuse of the DVB is the complexion of some of the biggest dissenters to women-friendly legislation. Says Jillani: “Institutions such as the Council of Islamic Ideology or the Federal Shariat Court, or for that matter, maulvis in parliament, are easily distinguishable. It is the conservative elements within mainstream, progressive/secular parties that are not, and a lot of resistance comes from there.” Both the Protection Against [Sexual] Harassment Act and the Domestic Violence Bill were unanimously passed in the National Assembly, but the hiccup came at the last stage – in the Senate, where the objections were raised.

Political appeasement also contributed to either stymieing altogether, or making an already slow and tedious legislative process even more so. Dr Bari says the PPP’s need to keep the JUI-F on board led to the stalling of the DVB, as the latter had raised objections to it, and that led to its lapse. Interestingly, after the withdrawal of the 18th Amendment, the DVB was turned over to the provincial legislatures, no longer remaining under the purview of the federal legislature – a development that has confounded many civil society organisations. Understandably so. How can a law on domestic violence not be applicable to the whole country? Jillani, however, advises: “Accept the changes and provincial autonomy, and move on and pursue [the issue] at the provincial level.”

This process has begun. In Sindh, the Home Department – with whom the Domestic Violence Bill surprisingly lies at the moment rather than the law department as one would imagine – has asked civil society organisations such as Aurat Foundation and the HRCP to present their recommendations.

Certainly, this is the right approach. Traditionally, civil society has been instrumental in the drafting and enactment of such legislation. It is due to the relentless effort and tireless work of organisations such as ASF, AASHA (Alliance Against Sexual Harassment), Aurat Foundation, HRCP and many others, on legislation, political engagement and lobbying with media and civil society that today even this much has been achieved. Another positive indication is the constitution of government-sponsored committees such as the National Commission on the Status of Women and the National Implementation Watch Committee, one headed by a former director of Aurat Foundation (see Interview: Anis Haroon), and the latter by the chairperson of AASHA (see Interview: Dr Fouzia Saeed). The commission and committee serve as unofficial intermediaries between the government and civil society – vital to push legislation through, since government bills carry the weight private bills do not.

The Protection Against [Sexual] Harassment Act, for example, was introduced as a government bill and thereby significant progress has been made since its enactment. The federal ombudsperson has been appointed. A code on gender justice has been adopted by government organisations and committees to hear complaints of harassment at the workplace and committees have been set up. As for the Acid Crime Bill, that currently lies with the Ministry of Law and Justice and Parliamentary Affairs, waiting to be vetted before proceeding to the cabinet. The Acid Control Bill, which deals with the monitoring and regulation of acid, is currently in the purview of the provincial ministries for industry and production.

All the positives notwithstanding, there is still a long, long way to go. While the struggle for the enactment of women-friendly legislation continues relentlessly, the war needs to fought be on several fronts, among them, educating and changing mindsets and lobbying with concerned individuals and the government.

Dr Bari reveals that on her visits to Adiala and Sargodha Jails for her research on the WPA, many policemen expressed their disapproval of the law contending that it “encouraged immorality.” Said one police constable, to bolster his anti-WPA stance: “Previously, women were put in jail. Now they are just killed because they can’t be sent to jail [on charges of zina].” And this mindset is not restricted to the police.

“I have judgments from the Lahore High Court (LHC) prohibiting marriage between consenting adult females and males,” says former senator and advocate, Iqbal Haider. “There was a case of a doctor who got married of her own free will, and the court said she could not do so. ‘Iss se berah rawi phele gi muashray mein. Muashra tabah hojai ga’ (If love marriages are sanctioned, waywardness will increase in society and destroy it). Their marriage was annulled and it was declared that without the consent of the head of the family, a marriage cannot take place. There is no justification for preventing an adult girl from marrying of her own free will. It has got nothing to do with Islam.” Haider took the case to the Supreme Court and had the LHC judgment set aside. Nonetheless, he maintains, “The fact is that there are certain judges who think like this and this [obscurantist] thinking has to be corrected. Our judiciary is still infected by the values promoted by General Zia-ul-Haq – not the entire judiciary, but some judges.”

And similar misogynistic attitudes are reflected in other sections of the judiciary too. There have been instances where session court judges have made a mockery of rape survivors in court, allowing the prosecution to do the same. This state of affairs requires “gender sensitisation,” training on a war footing and the “screening of people” joining the police and judiciary, says Dr Bari – especially at the senior level. Iqbal Haider says that a lot depends on the temperament, character and the will of the rulers. “Benazir Bhutto did not allow any ‘honour’ killing case to go unnoticed. We always used to go to the place of the incident and check the facts and figures,” he recounts. “My proposal was that if the SHO of the area fails to register a case of ‘honour’ killing, or does not arrest the killers, he should immediately be suspended and prosecuted for aiding and abetting the crime. I am a firm believer that moral and cultural norms and practices should be promoted, protected and encouraged by the ruling elite.”

Changing mindsets developed over years is long process. Says Omer Aftab, director White Ribbon Campaign, an initiative where men seek to end violence against women, it has taken 10 years to convince men that it is not okay to beat their wives – that too, by approaching the issue in a roundabout manner. As a campaign that is directed at the perpetrators of violence, Aftab found an unwillingness among men – factory and other blue collar workers being the main target audience – to listen to someone saying, “you should not beat your wife.” So to get the message across somehow, the issue was broached in another way: the men were told of the effects domestic abuse and conflict have on children. And that is when they started being more receptive.

There is no one absolute formula to effect change in this regard. It is neither a top-down approach nor a bottom to top route that is the answer or key to resolving the hurdles; rather it is a combination of both, and more. Mindsets remain key to introducing and enacting legislation, implementing it and creating a woman-friendly society. Clearly, awareness among the masses, police and judiciary is required as much as at the government, legislative and particularly, bureaucracy level. So whether it is by handing out appropriate punishments, adopting policy positions and implementing them, or campaigning and lobbying through workshops, trainings, seminars and media campaigns – all of it is required simultaneously. Only when more hearts and minds are converted, can real change begin.

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Know Your Territory To Remain In-Charge.

On February 18, 2012 By Jamal Ashqain In Blog, Cyber security, Gender, Privacy

Facebook, twitter and other social platforms are incredible tools to manage our social contacts and keep us involved and in touch with our friends, family and the social causes we care for, it can help extent your support to causes, involve in discussions and extend help and make a difference regardless of the constrains of political boundaries, and distances. It can also help you promote your self, your commercial services or help you vent out your thoughts and concerns.

It all seems fun , and game for some who are still no familiar to this whole whole new world of the new generation internet, but infect it is a serious business specially if you are a women and worst if you are even somewhat popular or known.

A few days back a friend of mine, who is a TV celebrity joint one of the social joint facebook, and since she was new in the game, she thought she could add all of her fans to the page. this is when the trouble started, first there was obscene martial posted on her profile, ( which actually is a seriously punishable crime if taken to the courts ) and later a number of her fake accounts started to appear on the web-sphere. another TV celebrity i know too faced the same sort of issues, her fake Ids tried to fool people she knew into adding her. I have known some cases where their pictures were taken off from their personal accounts and were published under with offensive remarks.

but the victims are not just TV celebrities. a number of groups take pictures of girls from several websites and post them on their own sites with obscene stories , remarks and content.

so how to avoid being a victim of such crime ? now if you are thinking it is best to stay off the internet that too would be a bad idea, because today in this age of technology getting a picture of yours would not be a problem. even someone at a restaurant may be clicking at you completely unnoticed to later put your images somewhere out there.

so the best way to survive and avoid being a victim is to first be active on the internet, know your territory well and include only the people you trust into your network. Keep the your photos locked and visible only to the people you know, who are on your friend list. keep the photos coming, don’t hold your photos from appearing on your profile but make sure the images you put there are publicly displayable, avoid putting up any privet photos on your profiles. Have plenty of pictures so people know who you are, and if someone missuses them they can come and report the issue to you and you can then at least announce it on your profile that your photo is being miss used.

most impotently never give out teh location of your house, your workplace on the internet or on your profile. always make sure you know people you included in your friend circle, confirm them via email or if he/she has a common friends ask those friends if they really know this person before adding them too your profile.

Don’t talk to strangers, don’t entertain them don’t let them walk into your house, that is what we were taught when we were kids, the same rules apply to your life on the internet. verify every person, his/her organization, her/his creditability, before you add them to your friends. Your profile is your space, if anyone is being rude to you don’t think twice, just click the remove button and keep him off your grounds.

Running away or quitting a social network and staying away from the internet will only keep the criminals active only you wouldn’t know of it, but if you are there on the ground you can fight and counter their attacks and stay in safe waters.

in short just don’t quit, face them and fight, and remember they really don’t stand much of a chance unless you give them one.

The Disgusting Ritual of Bride Hunt.

On February 18, 2012 By Jamal Ashqain In Blog, Gender

In our society as soon as a girl is born, we start telling her that her prime goal is to get married off, and without marriage her whole existence would be a useless burden for either her parents or her brother. In society such women are looked down upon with pity, “baychari ke shadi ke umer nikal gaee” in English we even have a word for them “spinster”. so from the day she is born it is taken for granted that this girl is destined to get married to be respected in the society.

The desperation of the situation becomes visible once the girl is old enough to be married off, Age 19 – 25 is consider the ideal age for a woman’s marriage, which is when the true disgusting state of the patriarch society comes to almost full visibility, at least to those who can see and have a heart that still has some sense of feelings attached to it.

When any possible marriage prospect (possibly eligible men) comes knocking at the door of the girl’s house, the girl is all dressed up in nice and presentable outfit and paraded in front of the man and his whole family, who are told that the girl is very timid, can cook well, she is good at maintaining the house, and is very religious. Timid: so she won’t raise a voice when her husband will beat her, she will do just as he asks her to, and follow him blindly, Good at Cooking and maintaining the house: She will cook, clean, and do all the housekeeping. Very religious: So religion can be misused to make her feel guilty and keep her further oppressed under the man’s thumb.

The boy and his family scrutinizes the girl, they look for other faults, mostly physical. Their eyes judge her body, complexion, height, weight, her eyes, nose, ears teeth, even breasts, and no i am not exaggerating or joking here. The boy forgets all about his own sister and mother. He looks – and not only that, all these things are discussed seriously in detail once the boy and his relatives are back at their home taking their sweet time announcing their verdict to reject or accept the girl.

The girl too is just another human. She can really tell by the piercing looks of the boy and his family that she is being scanned minutely from head to toe. Every physical aspect of her is in question. They are looking for signed of any fault in her body. she is being judged for only what she is but not who she really is. and then she has to wait, wait for days, thinking if this one will reject her, will there be another one, what faults will he find in her, is she acceptable in the society at all.

it is very rare that people would look for a bride on grounds of who she may be and not what she may be like. but for a boy anyone who is earning a good living, no matter how how he is doing that is considered an eligible match, His education, looks, his mindset are qualities which are almost never questioned.

its exactly like parading your commodity, like a goats or a cows in front of a possible buyer who would kept them well fed to milk them for his benefits. We don’t think twice what our own sister go through when they are judged for their physical outlook for marriage, and then rejected as if she was a piece of lifeless furniture which wont match the fine decor of his room.

But we follow this disgusting patriarch culture blindly without questioning it as if it is an unquestionable part of our religion just because that is what our society does. For the fear of what others may think, we become totally inhuman undermining women making them feel oppressed on yet another ground.
In our society as soon as a girl is born, we start telling her that her prime goal is to get married off, and without marriage her whole existence would be a useless burden for either her parents or her brother. In society such women are looked down upon with pity, “baychari ke shadi ke umer nikal gaee” in English we even have a word for them “spinster”. so from the day she is born it is taken for granted that this girl is destined to get married to be respected in the society.

Only very few lucky girls get an approval call from the first man they are paraded in front of. most of the time they are rejected a few times before someone approves of them. but the grounds on which the rejection comes are actually heart breaking. “The boy is saying she is too short” or “her complexion is a bit dull ” for some she may be too tall, or too fat, they might not find her eyes too attractive, or maybe someone wont like her teeth. it is very rare that people would look for a bride on grounds of who she may be and not what she may be like. but for a boy anyone who is earning a good living, no matter how how he is doing that is considered an eligible match, His education, looks, his mindset are qualities which are almost never questioned. its exactly like parading your commodity, like a goats or a cows in front of a possible buyer who would kept them well fed to milk them for his benefits. We don’t think twice what our own sister go through when they are judged for their physical outlook for marriage, and then rejected as if she was a piece of lifeless furniture which wont match the fine decor of his room.

The Reality of Breast Cancer

On February 14, 2012 By Farieha Aziz In Blog, Gender

This article was originally published in Newsline’s October 2009 issue

BreastCancer10 091 172x300 The Reality of Breast Cancer

Breast cancer is considered to be a curable form of cancer but only if it is detected early.

However, in a society where one does not speak openly about personal issues, especially those pertaining to our bodies – regardless of whether it is a medical condition – something that can be treated early is left to grow and spread, and eventually kill.

One such case occurred a decade ago, where an unmarried girl in her late 20s from an educated middle-class family noticed an abnormality in her breast. But she didn’t tell anyone about it – not even her mother or sister. The reason was simply the shame associated with speaking about that part of the body. It was not until she grew physically weak that the family noticed there was something wrong. A blood test and follow-up checks revealed that what had begun as breast cancer had spread to her entire body, and she died soon after.

Ten years down the road, attitudes have not changed drastically. Says Dr Azmina Valimuhammad, an oncologist at the Aga Khan Hospital: “The biggest stigma with patients suffering from breast cancer and why they don’t want to divulge this information is because they worry about their daughters; they say they won’t get married. Because of our ingrained religious beliefs, they also think this has something to do with a sin they have committed and see it as a form of punishment.” One particular patient’s sister-in-law wished the illness upon herself – she saw it as a means of purging herself of her sins in this life.
While these are some of the reasons why help is not sought, even when it is, it is on certain terms. One, of course, is a vow of secrecy: “A lot of patients who come to me ask me not to disclose information about them to their families; they usually prefer to keep it between the spouses,” says Dr Valimuhammad. Additionally, the cost factor also keeps many away from seeking timely help. “They don’t want to be a burden on the sole earning member of the family,” she adds. Cancer treatment – chemotherapy, radiation and surgery – is expensive and depending on the nature of the illness, can vary from Rs 5,000 to Rs 500,000 and more. Additional costs of tests such as biopsies, mammograms, ultrasounds, blood etc. are again costly – a biopsy needle and mammogram alone cost Rs 3,000 each.

Further, hospitalisation and doctors’ fees, in addition to the unrealised and unaccounted expenses such as travel costs and special food, are all a huge financial drain. Cancer also tends to turn into a lifelong illness. Once it has been diagnosed, there are always chances of a relapse, and to prevent that there is expensive medication one must take, that too without a 100% guarantee that it will prevent a relapse, or in turn create other serious health problems.

And there are also those who do not have the resources at all. For them, hospitals such as Shaukat Khanum in Lahore and Kiran Hospital in Karachi offer free cancer treatment, whereas government and private hospitals too have Zakat funds which can be availed by those who cannot afford treatment. What the Pink Ribbon Pakistan has done, together with the Institute of Nuclear Medicine and Oncology (INMOL), is launch a Breast Cancer Mobile Mammogram Clinic. Operational since March 2009, this on-wheels clinic, equipped with mammogram and ultrasound machines, travels to different venues – at the moment only in Lahore – where awareness camps are arranged by Pink Ribbon volunteers and provides free screening. This, too, however, has its limitations.

Not more than 20 women a day can be screened using the mammogram machine. Also, only those who are above the age of 40 can be screened through mammography – as the machines are not made to detect tumours in young breasts. But those who are younger can have their ultrasound and clinical examination done. INMOL radiologist Dr Asima Sohail and her staff of six technicians and nurses have so far detected three cancers through mammography and one through ultrasound and clinical examination. “What we do is opportunistic screening. We cannot screen every single woman, but those who are screened, their record is maintained and if something shows up in their mammogram or is detected through clinical examination, that person is referred to an INMOL hospital, where they are registered and a complete screening and follow up is conducted,” says Dr Sohail.

There is increased awareness about breast cancer now than there was a decade ago, but this increased awareness also has its consequences. Recently, indulgence in over-treatment sounded alarm bells in the US.

An article in Reader’s Digest reported an increasing trend in Americans to be aggressive about illnesses, “just in case.” A case is mentioned in the article of a patient with DCIS, a tumour in the breast which may or may not be cancerous, who underwent lumpectomy, radiation and took tamoxifen – a drug taken after cancer treatment to prevent its relapse – all of which is standard cancer treatment. The general trend is to frequently get mammograms and ultrasounds, and if a tumour is detected, to remove it, whether it is malignant or not. A consequence of this has been that these patients have developed several other serious health problems, be it because of surgery or medication.

“You don’t want to come across a patient telling you, ‘Doctor I had an abnormality and you did a biopsy. It was not indicative of cancer and you told me to take a watch-and-wait approach. Now, I was diagnosed with cancer and I had to undergo mastectomy (removal of breast),” says Dr Valimuhammad. “So, you don’t know when you’re seeing 10 patients who have low-grade, pre-cancer spots on the mammogram, should you wait or watch them or should they undergo mastectomy, because out of 10, 70% may never change into cancer, 30% will. Because we don’t have the tools to identify those women who will or will not progress into cancer, everybody deserves a chance – it’s over-treatment, but you don’t want to under-treat them either. You wouldn’t want to sleep with it everyday of your life thinking that this will turn into cancer and spread.”

Recent studies state that not only is the incidence of breast cancer on the rise, but Asian women are more susceptible to it and that Pakistan has the highest rate of breast cancer. Dr Valimuhammad, however, is not convinced. “I don’t think it is right to generalise or give such a big statement (that Pakistan has the highest rate of breast cancer and Asian women are more susceptible to getting it). We do not have the statistics or registrations of these patients to prove it.” According to her, just one study was conducted, and it was confined to the south of Karachi. “If you take that as representing the entire country, that would not be appropriate.” But with the possibility of breast cancer increasing among Pakistani women, what should one be doing? (See the related story Knowledge is Power).

The risk-free options are self-examination and clinical examination, which can begin at the age of 18. Those in their 20s can get an ultrasound, those above 30 can get an MRI and above 40 a mammogram. This is standard regimen for those who have cancer in the family. Other women, too, can follow this procedure, in fact should self-examine and get themselves examined. But ultrasounds, MRIs and mammograms should be performed only after consulting a doctor to avoid unnecessary exposure to radiation.

What all women should be watchful of, says Dr Valimuhammad, is hormone replacement therapy. “If one has to absolutely use hormone replacement therapy after menopause, then limit the exposure to a few months until the menopause symptoms have been controlled,” she says. Prolonged exposure to oral contraceptives, especially if taken at a young age, increases the risk of getting breast cancer. The more a woman is exposed to oestrogen, the higher the risk of getting breast cancer. Early menstruation and late menopause, not having children at all or having them at a late age, taking hormone replacement therapy and oral contraceptives all increase the amount of time a woman’s body is exposed to oestrogen.

Having children at an early age, having multiple children and nursing them for an extended period of time, on the other hand, are all seen to be preventive and reduce the risk of getting breast cancer. This is not religious propaganda but based on biologically proven facts. During pregnancy, for example, progesterone as opposed to oestrogen, becomes the dominant hormone. Tamoxifen, in turn, is also an oestrogen suppressant.

While lifestyle and eating habits do not have a direct correlation to breast cancer, according to research, obesity now does. “There is scientific evidence that insulin which is produced in our body – and is produced more in a person who is obese – is conducive to the growth of cancer,” says Dr Valimuhammad. Thus, avoiding alcohol and foods which can lead to obesity is encouraged. Physical exercise is also considered very important – not just to reduce weight. A study revealed that girls who were exercising regularly were able to delay the onset of menstruation at an early age. And if they indulged in heavy activity, then the menstruation cycle was also delayed and the frequency was decreased – instead of a four-week cycle they had a six-week cycle. And that was associated with decreased hormonal exposure and less chance of getting breast cancer at an early stage in life.

All these, however, don’t guarantee that one does not get breast cancer, but considerably decreases the risk of getting it.

Alternately, 5% of all breast cancer cases are linked to the BRCA 1 and 2, a gene abnormality which increases the risk of a woman developing breast and ovarian cancer before menopause. If two very close family members have been diagnosed with breast cancer and there is a history of ovarian cancer in the family, it is advisable for those women to get themselves tested. A blood screening determines whether someone has the BRCA 1 and 2. However, the psychological impact of testing positive, together with the implication of paying a high premium on health insurance, must be noted.

Those with the gene abnormality are justified in getting bilateral mastectomy before the cancer develops, according to Dr Valimuhammad, as is being done by women in the US who have unilateral breast cancer. By doing this, the risk of breast cancer is reduced by 5%. However, the risk of ovarian cancer still exists and so after having children at an early age, oophorectomy (removal of the ovaries) before 30 is also advised.

“If a woman consciously opts for the removal of both breasts, then she has the mental and emotional strength to cope with the cosmetic outcome,” she says. As for the physical implications, it has been observed that women who have had their ovaries removed die younger as opposed to their counterparts who have not had their ovaries removed. This is attributed to the high cardiovascular mortality, because the removal of the ovaries leads to early menopause which increases the risk of heart disease. Early menopause does also lead to osteoporosis and arthritis.

But while there is so much emphasis on prevention, there is very little available in the way of counselling and medicinal advice for those who are undergoing or have completed their treatment.

Sameena, now in her third year of remission, was diagnosed with breast cancer at the age of 47. “I had an outward symptom, a dimple. I wasn’t aware this was one of the symptoms, I had heard forever about how to inspect yourself and look for lumps but now they tell you that any kind of discolouration, a mole, redness, swelling – anything you see on your breast you should report. Anyway, my doctor told me a dimple was a sure sign and I had been watching it grow for six months.” Since Sameena had recently moved back from the US, she did not have a doctor of her own and it was on a chance trip when she accompanied her sister to a gynaecologist that she was told to get a biopsy. The biopsy report confirmed the cancer.

Undergoing treatment at Shaukat Khanum, Sameena says she is thankful such a setup exists in Pakistan, but there are drawbacks to free treatment. “One oncologist is dealing with several people; you are given an appointment for 10 a.m. and your turn comes at 1 p.m., which gets frustrating.” Put on tamoxifen after undergoing chemo, radiation and lumpectomy, Sameena threw the medicine away after three months. “It had such strong side effects. It was making me obese and my face became full of hair. I told my doctor if I’m going to live looking like a sumo wrestler I’d rather die! It also makes you manly, develops your muscles. I know two people who had breast cancer before I did and both had tamoxifen for a five-year period, without fail. One’s cancer has returned after 10 years and the other’s after eight – so I said I’ll take the risk.”

Kausar, diagnosed with breast cancer in 1991 at the age of 40, also does not have pleasant memories of the years with tamoxifen. “I suffered from acute depression and it had terrible side effects. I had seen relatives of mine going through chemotherapy and the effect it had on their lives; it worsens the quality of life.” So, Kausar chose surgery and tamoxifen over conventional chemotherapy and radiation, and after five years of tamoxifen and annual ultrasounds, bone scans etc., she grew wary of those too and gave it all up for a herbal remedy.

Counselling and support other than that from the family is missing in Pakistan. “People need to be told exactly what will happen to them when they undergo the treatment. Also, you’re left to the technicians and the machines.” Being single, Kausar didn’t have a family member accompanying her each time for a hospital visit, and sometimes, “you don’t want to confide your fear and anxiety to close family members, such as how long will I live,” she says.

The lack of support groups is a unanimous concern for most breast cancer patients. “They have them in the US, where women with breast cancer get together and talk,” says Kausar. Dealing with the illness psychologically is one of the biggest challenges. Breast cancer is an illness which physically manifests itself. “It is not like a hysterectomy which is something internal. You feel mutilated, physically made uglier; you don’t want to look at yourself.”

Feminine roles ascribed to women in Pakistani society require them to play wife and mother, primarily. Removal of the breasts and ovaries can have a considerable psychological impact on women. While the removal of the ovaries becomes unavoidable in some situations, there are now ways of performing what is called the breast-conserving procedure.

“When one has breast cancer, they can either have the complete removal of the breast or they can have what is called the breast-conserving procedure,” says Dr Valimuhammad. “In the breast-conserving procedure there is only the removal of the lump, followed by radiation. It is as effective as the complete removal of the breast. There are situations in which they can do a nipple-sparing mastectomy or skin-sparing mastectomy in which they remove the entire gland – the breast tissue is basically lobules and a gland, so they can remove the fatty tissue and they can leave the skin and nipple area, and fill the gap either with a muscle from the back or belly, or put a silicon implant. It all depends on the location of the tumour and the feasibility of the procedure. One procedure doesn’t apply to everybody.”

Sameena feels the people also need to be educated on how to react to breast cancer patients. “When you’re hairless, eyebrow-less and eyelash-less, people look at you.” Kausar says people don’t know whether they should speak of the illness or not, and for her, it became very uncomfortable at her work place. “I was given the same kind of hours at work, nothing extra; there is so much pain after the operation, you can’t even move your arm. You just don’t have the same strength left anymore.” So it is not only about creating awareness about breast cancer, how to check and treat it, but also what can be done for those who are currently undergoing treatment and those who are recovering, to provide them complete treatment, which includes dealing with the psychological impact of the illness as well.

What is also required is a Pakistan-specific study; oncologists around the country need to get together on a single platform to pool their studies and findings, case histories, and share this information with the public. The inability to work together, as Dr Valimuhammad also says, is a problem in Pakistan, and everyone strives to be the first at everything which keeps them from coming together. But unless this happens, accurate findings of whether the incidence of breast cancer is higher in Asian and Pakistani women and why this is so, is unikely to come forth.

Simple Facts about Breast Cancer

BREAST CANCER – WHAT ARE THE RISKS?
No one knows why some women and even some men get breast cancer and others don’t, but certain factors increase the risk. They are:

Age – The older you are, the higher your risk

Gender – There is a link between breast cancer and the female hormone oestrogen

Family history – If your mother or sister has had breast cancer, risk of getting it rises

Age at first child birth – Women who had their child at the age of 30 or later

Age of first menstruation & menopause – The earlier women begin menstruating, the higher the risk seems to be. Women who enter menopause between the ages of 45 and 54, have a higher risk

WHAT TO DO AND WHAT TO LOOK FOR
Breast self examination should be performed once a month after your menstrual period, when the breast is not tender or swollen. If you are not always regular, do it on the same day every month.
Don’t get upset if you feel some lumps or hardness, that’s normal. It is also normal if your breasts are not exactly the same size.

A lump in the breast which is usually single, firm, and most often a painless or local thickened area

A portion of the skin on the breast or underarm swells and has an unusual appearance

Veins on the skin surface become more prominent on one breast

An unusual increase in the size of one breast

The breast nipple becomes inverted, changes in skin texture, or has a discharge other than breast milk

A depression is found in an area of the breast surface

Swelling of the upper arm

A rash or eczema on the nipple or around it

Courtesy: pinkribbon.org.pk

Portrait of Dishonour

On February 9, 2012 By Jehan Ara In Gender, VAW

Portrait of Dishonour
By Farieha Aziz 27 JANUARY 2011

Niilofur Farrukh. Photo: Jamal Ashiqain

“No Honour in Killing: Making Visible Buried Truth,” a show intended to raise social awareness through art, was initiated as a project in 2008, soon after the Naseerabad ‘honour’ killings made the headlines. According to its curator Niilofur Farrukh, it began as an attempt to fight the helplessness that had gripped society when news of the murders broke.

Dedicated to the four women who were buried alive in Naseerabad, the exhibition, which went on display at the VM Gallery last month, showcases the work of 35 artists – some very well known, others young and upcoming – with each work exploring a different dimension of violence against women.

The first work that catches the eye comprises two white muslin sheets suspended from the ceiling covered with fiery orange text and screen print. Titled ‘Wajud-e-zan say hai tasveer-i-kainat mein rang,’ artist Meher Afroz conveys her thoughts on ‘honour’ killings through the use of specific words and phrases on her canvas. Words such as amal, masawaat, akhuwat, yaqeen, rawadari are scattered around a poem that reads: Nai ho ya purani/ zann ka nigehban hai faqat mard/ jis qaum ne iss zinda haqeeqat/ ko na paya/ uss qaum ka khursheed bohat jaldi/ huwa zard.

‘Honour’ by Khuda Bux Abro features moustaches floating around a burqa-clad woman. Men who brandish these moustaches – which are viewed as a source of pride and honour in society – think nothing of laying to waste a woman’s life in the name of honour. The painting depicts the entrapment of women by such men and their code of honour.

In Naima Dadabhoy’s work, a screen print on canvas, the map of Pakistan placed at the centre of the canvas, is surrounded by text that documents facts, figures and perceptions relating to ‘honour’ killings. More impressive, however, is Dadabhoy’s life-size skeletal structure of a woman resembling a mummy lying on the floor in wrought iron and tin foil – much like a corpse in a coffin.

Maham Mujtaba depicts the debasement of the concept of honour by draping a wild boar in her painting with a red sheet that has the word ‘honour’ embroidered on it. The background shows 18 women wrapped in white sheets – all victims of ‘honour’ killings.

What look like two double-sided axes strung on the wall are the product of a collaborative effort by Abdullah Syed, an artist based in Sydney, and Roohi Ahmed, currently a teacher at the Indus Valley School of Art and Architecture. Titled ‘Kullah-Re,’ on one side of the wooden stick is the metal component of an axe whereas on the other is a kullah (form of turban) made of fabric. Together, they denote the perpetrator of violence and the tool he uses to perpetrate it – the tribal lord and the axe.

Covering most of the wall space on one side of the gallery, Marium Agha’s ‘72 virgins for my suicide lover,’ references the promise of 72 virgins to all martyrs in a Hadith in an unusually interesting manner. Instead of using figurines, Agha uses biological sketches of the vagina to illustrate the reduction of women to mere objects, offered as reward in heaven – and on earth.

Strikingly different is Maria Aftab’s work in mixed media. Done in bright red fabric with a checkered rug on the floor and a floral design on the wall, Aftab’s bathroom scene and fittings – a sink and a mirror with a towel rack next to it – according to her represent “items of daily use … which usually provide comfort yet simultaneously give the effect of a nightmare.”

On a more positive note, Sana Arjumand uses a portrait of a woman wearing a crown to depict Mukhtaran Mai. It is her way of paying tribute to a woman who was the victim of a heinous crime – gang-rape – but stood strong in the face of slander, threat and coercion and came out of the trauma as a stronger and better person – a role model for victims of similar tragedy.

“At some level or the other, art communicates – sometimes directly and at other times, not so much,” remarked Farrukh of the show. According to her, the aim of the exhibition was to dispel the widely held notion “that art is merely an elitist activity and expresses itself in an esoteric idiom.” In her address at the two-hour discussion/dialogue prior to the exhibition’s inauguration in Karachi on December 6, Farrukh stated that the initiative aimed to do three things: take the exhibition to different parts of the country, include the work of local artists and initiate a dialogue.

While the exhibition could not travel to several cities listed on the scheduled programme due to the worsening law-and-order situation in the country, it made it to Jamshoro, Khairpur, Islamabad, Lahore and finally Karachi. Similar discussions as the one in Karachi were held at these locations. Most of the students, particularly those in Jamshoro and Khairpur, were well aware of the crimes committed in the name of honour and the perceptions that existed in their respective societies. Not only were they very forthcoming in their discussions, but also contributed to the exhibition – selected works were added to the core exhibition.

At the event in Karachi, after the screening of Beena Sarwar’s nine-minute award-winning documentary Mukhtaran Mai: A Struggle for Justice, several speakers addressed the audience. Khadija from Shirkat Gah, one of the researchers who travelled to Naseerabad on a fact-finding mission, presented an overview of the widely practiced – and accepted – cultural practices in Naseerabad and its five adjoining districts. She said watta-satta, siyakari and karo-kari were rampant in the areas. Women were killed in the name of family honour – even on the pretext of leaving home unaccompanied or without the permission of a male member – and commonly used as barter for hefty sums of money

Amar Sindhu, an activist from Hyderabad, added to the discussion by informing the audience that the notion that the jirga system provides “cheap and easy justice,” did not hold true. As much as 1 crore 16 lakh rupees has been given as compensation money to settle disputes. ‘Honour’ crimes, said Sindhu, had become part of the country’s political economy, with feudal lords – some of whom are sitting in the assemblies – getting a percentage of the compensation money. Sindhu added that the perpetration of these crimes against women in particular was due to a lack of female representation in the jirgas. She gave the example of a female politician from Sindh, who despite being an elected representative of the area, was not allowed to intervene while an all-male jirga was in session. And despite the Sindh High Court’s ban on jirgas in 2004, they still operate, with ‘honour’ killings rising with each passing year.

Poet and activist, Attiya Dawood recited her poem, ‘To My Daughter,’ originally written in Sindhi but translated into Urdu, with “pyaar zaroor kerna” being the constant refrain. The floor was then thrown open to the audiences and a lively discussion ensued. One member suggested that events such as these should be held in areas where these crimes are perpetuated instead of urban centres. A female in the audience countered by saying that while women may not be killed as blatantly as they are in rural societies, the concept of family honour is linked to women even in the urban areas.

Moreover, members in the audience pointed out that it was people based in the urban centres who could effect change by approaching the relevant people and authorities, and further through their activism and agitation. The powerful and the influential needed to be converted, for even if they were not sanctioning the crimes directly, they were on occasion guilty of abetting the act. And some anti-women laws needed to be changed, as was pointed out by WAF (Women’s Action Forum) member Nuzhat Kidvai, and other laws in favour of women needed to be implemented.

All in all, the exhibition-cum-discussion managed to strike the right chord in most hearts.

Smile Again!

On February 5, 2012 By Sana Saleem In Blog, Gender

I first met Salma at a school-turned relief camp in Hyderabad. We were there to distribute rations and Eid gifts for children a day before Eid. The thought of seeing a smile on the children’s faces at the sight of new clothes, shoes and bangles kept us restless for days, until we finally began the distribution.

We entered a dimly lit room, crammed with women, children and swarming flies. Children had lined up against the walls, anxious as we unpacked the clothes and began to hand them one by one. Most of them were extremely eager, coming forth and beaming confidently as soon as we took out a dress that matched their size. It is here that I came across Salma. She was fidgety and as soon as I handed over the clothes to her, she immediately ran back and hid behind her mother.

Seven years of age, Salma has a cleft palate. Cleft palate is a birth defect that affects the upper lip and roof of the mouth. This happens when the tissues that form the roof of the mouth and the upper lip don’t join before birth. The problem can range from a small notch in the lip to a groove that runs into the roof of the mouth and nose. Apart from the physical deformity, patients with a cleft palate have difficulty eating, talking and, at times, the condition could lead to severe ear and lung infections. Additionally, since these children do not have a hard palate, they are not able to suck, which leads to an increased number of deaths during infancy.

Fortunately, Salma had survived the ordeal as an infant because she was not breastfed. But her deformity could lead to other, more serious and fatal medical problems. The only solution to this problem is a hard palate surgery and lip reconstruction. Even though providing such specialised medical assistance was not part of our relief efforts, my concern for Salma’s future motivated me to go beyond the usual relief efforts. After all, she would probably never have access to an expert in cleft palate surgery.

Before we left the camp that day, I asked her mother if she would agree to a surgery if one could arrange for it, and she said she would be more than willing as it would change her daughter’s life forever. Within days, we were able to find a surgeon: Dr Ashraf Ganatra, project director of Smile Train, a US-based non-governmental organisation involved in helping patients with cleft lip and cleft palate across the world. He carried out the surgical procedure free of cost.

I cannot forget the tears of joy in Salma’s mother’s eyes. She said that the floods had turned into a blessing for her, a miracle that had changed her daughter’s life forever. Salma is now back in her village in Hyderabad, after a successful hard palate surgery. Her lip reconstruction is due after six months and her family has promised to bring her back to Karachi for the procedure.

Mukhtar Mai Fearful For Her Security

On February 5, 2012 By Farieha Aziz In Blog, Gender, VAW

This article was originally published on the Newsline blog on April 28, 2011

With the arrival of the acquitted men back in the village, Mukhtar Mai is now fearful for her security. The programme manager for the Mukhtar Mai Women’s Organisation and her spokesperson, Naeem Malik, tells Newslinethat since the release of the five men on April 26, frantic requests were made to media and government senior officials to help avert any potential harm to her.

There was a flurry of activity in the next 24 hours: Mukhtar Mai and her organisation made calls, sent out letters and even appealed to Rana Sanaullah on a live television show for security. MNA Sherry Rehman took up the matter with the federal interior minister; the National Commission on the Status of Women sent a letter of request to Punjab Chief Minister Shahbaz Sharif and the IG Punjab; and activists and citizens with links to anyone within the government and media tried to push the issue of Mukhtar Mai’s security. And finally, later in the day on April 27, the intervention produced results and six policemen were deputed outside Mukhtar Mai’s residence.

Meanwhile, the acquitted, who on their release chanted slogans against Mukhtar Mai, were thrown a festive bash back home, and mithai was distributed. People will argue that this is but a natural reaction. After all, the Supreme Court found them guilty of no crime, and now they have returned home and been reunited with their families after some years: for them, it is an occasion to celebrate. As for Mukhtar Mai, they claim she is just overreacting.

Overreacting because she was gang-raped? Or overreacting because she is scared that the acquitted will want to avenge their years in jail? Or maybe because in this country, not just in her case, but in many, it is easier for a person to commit a crime and get away with it, than to commit a crime and be punished for it.

The crime that was committed against her is mentioned only in passing. That of course is not the important argument. What’s important for people is whether the threat to her is ‘real’: whether she deserves security.

The common man knows exactly how the truth is moulded to suit personal and political agendas. But frighteningly, he is buying more and more into the dirty tactics of those trying to mould public opinion for their own gains. By stooping to character assassination, there seems to be a concerted effort to cast a shadow of doubt about Mukhtar Mai’s case and character. Be it TV anchors or government representatives, people are involved in the dirty game of victimising the victim and are aggressively hammering home the view that there is no credible case there at all.

Rape survivors know only too well the dynamics of such a situation, especially when they are up against those with political clout. They also know what it is like to be promised aid by government officials and never hear from them again. To be the media darlings and then be dumped when they aren’t “newsworthy” anymore. Theirs is a daily struggle, and while they have the strength, they look for some respite to keep them going. Dismissive attitudes don’t help, especially not when the law enforcers and policemen are the first to taunt, saying to those who come to file an FIR for rape, “Barri aiee Mukhtar Mai banain.” (See also this article for an exploration of women-related legislation and misogynistic attitudes that exist in our society). Who knows how they will ridicule women who go to file an FIR for rape now, or whether they will go to file one at all.

It took great resolve for Mukhtar Mai to agree to the review, because she had lost heart. But eventually she decided to persist in her struggle. This is what Mukhtar Mai had to say: “Please keep the issue alive. They have strengthened jirgas and waderas (feudals) back home and let down the poor women of Pakistan. Let’s fight it together.”

So naturally, now that the acquitted are living only some miles away from where she does and have exercised considerable political clout, she has concerns for her safety, especially while the review process runs its course.

But what it really boils down to now is public opinion: in the end, it is opinion and the mindsets that dictate the tone for justice. There is nothing criminals celebrate more than for their crime to not be considered a crime. So when murder and rape take place, don’t invent excuses for them. Call them murder and rape, and condemn them for what they are: atrocious acts against humanity. Acts that can be committed against any one us any day. But no one will care, because we certainly don’t when the same happens to others.

From Newsline’s archives:

The crime is only the beginning of a tougher life. There is the arduous legal route (see “The Legal Trauma of Rape”) which poses hurdles of its own, and social ostracism that rape survivors and their families have to contend with.

Below are a few more articles that look at the lives of those affected by rape:

“Fight to the Finish”: While the Women’s Protection Act 2006 solved one of the many legal hurdles that lie in the way of a survivor seeking justice, many remain to be faced.

Interview with Hamza Lubano: His daughter Naseema Lubano was a victim of gang rape, and the family had to flee their village.

Newslinespeaks to the parents of a 14-year-old girl who was raped.

Interview: Anis Haroon, National Commission on the Status of Women

On January 25, 2012 By Farieha Aziz In Blog, Gender, VAW

This interview was originally published in Newsline’s March 2011 issue

Anis Haroon

“The government has the political will,
but we face hurdles from the bureaucracy”
- Anis Haroon, Chairperson,
National Commission on the Status of Women

Q: What authority does the National Commission on the Status of Women have as a body?

A: The NCSW is a statutory body. It is supposed to make recommendations on policy and legislation and, simultaneously, act as a watchdog body to see if the policies or laws are being implemented, including the international instruments such as CEDAW. When the commission was created in 2000, it was brought through an ordinance. According to that ordinance, the commission’s secretariat is the Ministry of Women’s Development (MoWD). This means that for everything, we have to go through the ministry or refer to it and it goes into the same bureaucratic process.

NCSW’s role is very different from that of a government ministry. When we disagree, we say it openly. We write letters to the PM, president or the various CMs. We write 10 letters and get one reply. I am told because I come from an NGO, I don’t know what government procedure is. They say “We send the file and we are not even allowed to send a reminder before two weeks.” Then they respond. The files are passed around over a period of some months. I feel all bureaucracies are slow but ours more so.

One thing the commission is demanding is the power of investigation under the Inquiry Commission Act of 1956. This demand has met with a lot of resistance from all the ministries. The argument that these are judicial powers and will establish a parallel legal system keep coming up. We keep having to explain that we will refer the case to a magistrate, but as far as the investigation goes, the police will be bound to update us on developments, and we will present our findings and reports. Once we get this power, then we will be authorised to make the authorities answerable and we can also be a part of the investigations. We don’t have the capacity to get involved in every single case, neither are we going to set up a court of our own; we will just act as a watchdog.

Last year on March 8, the PM had announced that he had decided to give full financial and administrative autonomy to the commission. In a meeting with him in February, I asked him what he would say this 8th of March since it hasn’t happened. He was not at all happy with this development and asked all the secretaries concerned, especially Shahnaz Wazir Ali who was there at the meeting, to facilitate the autonomy of the commission.

Q: So the autonomy of the commission is something that has been decreed but needs to be brought into effect…

A: Yes, but we also want that this should not remain in the form of an ordinance. Once it goes through the cabinet division, it should go to the National Assembly (NA), so the parliament should also agree to the commission’s autonomy. Once it goes through the cabinet, then it becomes a government bill. We have given many presentations to the Women’s Caucus and the parliamentarians on this, so I don’t see any hurdle for it to be passed through the cabinet.

However, it is still a long process, and if we are able to get it through the cabinet before March 8, it will be a big achievement.

Q: What is your opinion of the Women’s Caucus, and how effective has it been with regards to women-related legislation?

A: It could have been much more effective than it has been. The formation of the caucus is a very positive step; at least you can shake up the members and ask them what is happening and why they aren’t doing something. But somehow, I feel that the process of legislation is so tedious and so slow that you need to have a sizeable number of legislators to focus on the agenda of legislation. The members of the caucus are involved in so many other activities: someone is the chair of or part of another committee, someone is travelling back and forth. The Women’s Caucus should form a legislative wing. There’s a standing committee on women’s rights in the NA and the Senate, but somehow I feel that the focus on the legislation or expediting the legislation is not there.

Q: Do the legislators take the recommendations of the NCSW or civil society organisations such as the Aurat Foundation and the HRCP, seriously?

A: In the case of the Domestic Violence Bill and Protection Against [Sexual] Harassment Act 2010, their recommendations were taken. It was discussed threadbare in the national committee for women’s rights. AASHA really worked hard on the Harassment Act. There is definitely space, but I feel there is so much political upheaval all the time, so much political instability, and this stops the entire process and then you have to start from scratch again. Right now the Raymond Davis case has taken over everything. Issues keep cropping up one after the other, and hamper our work. We keep working but everybody else’s focus shifts.

We have formed a legal committee which consists of retired justices like Majida Rizvi, and lawyers like Hina Jillani and Dr Fakir Hussain. From Quetta we have Kailashnath, who is working on minority rights and family laws. A lot of work has been done by the legal committee and has been accepted and appreciated. But somehow with all this political upheaval or disaster, the momentum gets lost. That’s the difficult job – to keep stability and momentum.

And then there are so many changes in the bureaucracy. Since I’ve been there, three secretaries of the MoWD have changed. Initially, the women’s portfolio was with the PM, except for the last few months when it was given to Firdous Ashiq Awan. And before she could understand what it was all about, she got the Ministry of Information. So I suppose again it has gone back to the PM, and he is a very busy man.

Q: Is this ministry taken seriously by those in government?

A: Well, as far as the political government is concerned, the PM takes it very seriously, but with the different departments or ministries, women don’t really figure on their agenda that much. Theirs is more of a ‘Chalo bhai karna he hai to kar dete hain’ (if it has to be done then we’ll do it) attitude when it comes to issues pertaining to women. They don’t consider it their priority or their mandate. Whenever the push comes, they do something and then they take a backseat.

Q: It seems that whenever there is a piece of women-related legislation in question, there is pressure especially from the right-wingers, who find something or the other wrong with it, and it’s always difficult to push such legislation or amendments through…

A: Every party has rightists. It is very tedious work to manoeuvre. It was very difficult to get the Protection Against [Sexual] Harassment Bill passed and we were very happy when it was passed by the NA. But the way it was stopped in the Senate was very disappointing – there was no need to do it.

Q: The Domestic Violence Bill has turned into a provincial matter because of the 18th Amendment. Isn’t this a bill that applies to the whole of Pakistan? And was it only because of the 18th Amendment that the bill lapsed in the Senate, or were there objections to the bill itself?

A: Actually what happened was at the time all the focus was on the Kerry-Lugar bill and the PPP needed the support of the Fazlur Rahman group, which had raised objections about the bill, so it was never put up for voting. We were 100% sure that if it had been put for voting in the Senate, it would have carried through, because the MQM, PPP and ANP [would have supported it]. But somehow because of this political compromise, a mediation committee was set up, and without being voted on, the bill was referred to the committee. When the committee had almost completed its work and everything was finally sorted out, there came the 18th Amendment.

There is a via media – that’s what we were told by the implementation committee of the 18th Amendment, headed by Raza Rabbani. The legislative body insists that they can introduce this bill in the joint session of the assembly and it can be passed from there, but the implementation committee says it will have to go to the coordination committee which the chief ministers of all the provinces are part of. Either the coordination committee should approve it or, alternately, at least two provincial assemblies must pass a resolution in order for this bill to be taken up by the NA again. The legislators are not very clear about the procedure though.

Q: Aurat Foundation and the HRCP were summoned by the Sindh Home Department and asked to present their recommendations on the Domestic Violence Bill. So the bill now lies with the home department, and in their notification the department expressly states that this is not a federal matter and will be taken up by the Sindh Assembly.

A: I’ve spoken to the ministers concerned in the provincial assembly and we also gave them drafted resolutions. But based on interaction with them, it appears that the provincial government wants to bring its own version of the bill on domestic violence.

Q: The Council of Islamic Ideology stated that the divorce rate would go up if the Domestic Violence Bill were turned into law. What say or weight does the council have as far as legislation is concerned?

A: The council is also a recommendatory body which is [supposed to] see to whether laws are in conformity with Islamic injunctions. But they go beyond that; they claim they have the role of rejecting laws that are not in conformity with Islam. The Women’s Action Forum (WAF) and many other civil society organisations have been asking for abolition of the Federal Shariat Court and the Council of Islamic Ideology. Once you have Islamic provisions in your constitution, you don’t need separate bodies like these.

Nobody has been able to do anything. The civilian governments have always been very weak. And they don’t have that much political clout. I don’t think PML-N’s agenda is progressive. It’s only with the ANP, MQM and PPP that hope lies, and some members of PML-Q and PML-N. But when you look at the composition of the coalition, the present government is not a very powerful one.

Q: Some sections of society believe that the Women’s Protection Act (WPA) 2006 came about because the government had taken the initiative and it presented the bill. So is it that in comparison to private member bills, government bills are more powerful?

A: Actually, it was moved by Sherry Rehman as a private members bill and members of the PML-Q joined in. So it was all about clout.

However, government bills have ownership, which the private member bills don’t. So it is very important that the government take ownership – of the Acid Crime Bill for instance. Yes, Marvi Memon and Justice Fakhr-un-Nisa did a good job, but those were just amendments in the Pakistan Penal Code. What we need is a comprehensive law. We have worked with the Acid Survivors Foundation (ASF) and the legal committee has given a draft which has been approved by the CFOs and the ASF, and we are pressurising the government to take it up.

When Firdous Ashiq Awan was there, she was keen to take it up, but then she knew the ministry was going to be devolved so her interest also shifted. They have to give priority to women.

Q: At the moment, on the WPA front we have the Federal Shariat Court verdict. Has the government filed an appeal?

A: Not yet. The government has six months to file the appeal but some of the civil society organsations – HRCP, WAF and Aurat Foundation – have filed one. But the law ministry should go into appeal. If it doesn’t then the NCSW will also have the option to go into appeal.

Q: We have seen a sharp rise in the incidence of violence against women; several cases have been reported even in these two months of 2011. We are hearing of ‘honour’ killings, acid crimes etc quite frequently again.

A: This is because there is a serious breakdown of the state machinery, both at the provincial and district level. Those who have the power of the gun or all the political power, I believe, have their own agendas. When the conviction rate is so low, how can you expect that these crimes will go down?

Q: How do you think laws impact the collective psyche? Or do you think they have any effect at all?

A: I do believe they have an effect. The argument that is made is: so what if there are laws, there is no implementation. But that is a different set of arguments; for that we have to get into the judicial reforms and the police reforms.

One of the eight researches we conducted in the last two years was on the impact of the WPA. And our research shows that since 2006, not a single woman has languished in jails on charges of zina. This is what I know Sherry Rehman wanted to do for the Blasphemy Law as well. But unfortunately it was mishandled.

I have been part of the women’s movement and I believed in WAF’s stance on the repeal of all discriminatory laws. With the situation at the moment, if we cannot go for repeal, let’s at least provide relief to innocent people or innocent women who are becoming victims of unjust and discriminatory laws. Also, I feel it is very important for legislators, particularly women legislators, to think seriously about taking the legislation forward.

Q: How can legislation help? Each time a case is taken to court, proving the crime becomes such a task…

A: You have to have a mechanism. Like with the Protection Against [Sexual] Harassment Act, the commission has formed an implementation watch committee and all the government and semi-government institutions are on board – and we are increasing the net. The complaints have already started coming. Some decisions have gone in favour of the victims but some have gone against them; this is a process that one has to follow, and it will take time. In December, an ombudsperson was appointed. She still has to start her work.

Q: What will her duties be?

A: A report goes to the committee and if you don’t have faith in the decision of the committee, then you take it to the ombudsperson. So there is an authority outside of your organisation to look into the matter.

Redressal mechanisms have to be improved too. Of course we are focusing on women, but it is tied up to the judicial system of the country and the law-enforcing agencies. Unless you reform the police, and there are judicial reforms, particularly of the trial and sessions courts, and lawyers and judges, little can be achieved. Their level of awareness needs to be changed. They should have knowledge of the laws that exist. Most of the small places don’t even know about the WPA. And I am talking here not of the common man but the police, the lawyers and sessions judges.

So the implementation will take time. Everything is about a change of mindset, and it is so difficult to change. But once people know that there is a law, then there is some apprehension and they are forced to think ‘if we do something, then action can be taken against us.’ Once you start convicting people, then only will we see the effects. Conviction, implementation, etc, all these things have to be monitored.

Q: Monitoring is a huge task. As a commission, do you have the resources?

A: Naturally the government doesn’t have enough resources. There were some resources available to AASHA. They are setting up the provincial and district level committees. The NCSW is a sort of umbrella organisation which is monitoring and providing facilitation for this implementation. There is a need for more women judges. We don’t even have that quota. Neither in the police or judiciary, nor in the election commission. The government had announced that all quotas in government departments would be increased from 5 to 10%. But quota doesn’t mean they should be inducted at the lower cadre only; they should be placed within the hierarchy as well. These things have to be addressed. It’s an uphill task. It’s like one step forward and two steps backwards. It’s a constant struggle.

Q: What would you credit the commission with, in terms of what is has been able to achieve so far? And what will be the commission’s agenda this year?

A: This year, we want to focus on the family laws, especially for women belonging to minority communities. That is one way of protecting minorities and taking their agenda forward. And we are focusing on the legislation and amendments, and making the commission fully autonomous – and I tell you that the government has the political will to do so, but we face hurdles from the bureaucracy. When it comes to government policies, they would like to maintain the status quo; it works in their favour. The commission has to be retained as a federal body of policy, at the policy level under the 18th Amendment.

The other thing is that I still find the Zia-ul-Haq legacy very strong, especially in Islamabad. In his time, we were out on the streets shouting that all discriminatory laws should be repealed. And though it was a dictatorship, we could do that. But now civil society feels so intimidated by what happened after Salmaan Taseer’s death, that people have become very cautious. We do have a silent majority that agrees with all the proposed reforms, but they don’t talk about it, they don’t come out openly in support of it. The problem is, the other side says the Domestic Violence Bill should not be passed and they come out in the thousands against it. We say it should be passed, but only a handful come out. So either the liberals and progressives in the country have left the matter entirely to the ruling elite, or to the religious parties.

I see the commission as being in between the government and civil society. The more pressure civil society puts on us, the more pressure we will be able to put on the government. I was told by one of the senior MNAs in the Khyber Pakhtunkhwa government that Nizam-e-Adl was ‘the demand of the people.’ So it seems women need to create ‘a demand’ for their rights. The dissent must be kept alive.

Q: What is the legal recourse to getting rid of Zia’s legacy?

A: Get rid of the 8th Amendment. The constitutional reforms committee that was formed asked NCSW to give its recommendations, so we had a national consultation and proposed that they go back to the 1973 constitution without any amendments in it. It would have taken care of all anti-women laws, the so-called Islamic laws and even the amendment made by Zia to incorporate the Objectives Resolution into the constitution and the clauses about the Ahmedis inserted by Zulfikar Ali Bhutto. But it wasn’t touched.

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“The government has the political will, but we face hurdles from the bureaucracy” - Anis Haroon, Chairperson, National Commission on the Status of Women

“The government has the political will,
but we face hurdles from the bureaucracy”
- Anis Haroon, Chairperson,
National Commission on the Status of Women