Dawn Editorials (with Summary and Vocabulary)
DAWN EDITORIALS
January
12, 2024 (Friday)
Day’s Vocabulary
- Menfolk. a
group of men considered collectively, especially the men of a particular
family or community
- Aeons. an
indefinite and very long period of time
- Vehemently. in a forceful, passionate, or intense manner; with
great feeling
- Unscathed. without
suffering any injury, damage, or harm
- Misogynistic. strongly prejudiced against women
- Relinquish. voluntarily cease to keep or claim; give up
- Ostracised. exclude (someone) from a society or group
- Vilified. speak
or write about in an abusively disparaging manner
- Regressive. becoming less advanced; returning to a former or less
developed state
- Patriarchal. relating to or characteristic of a system of society
or government controlled by men
- Bigoted. obstinately
or unreasonably attached to a belief, opinion, or faction, in particular
prejudiced against or antagonistic toward a person or people on the basis
of their membership of a particular group
- Alleviate. make
(suffering, deficiency, or a problem) less severe
- Menace. a
person or thing that is likely to cause harm; a threat or danger
- Denounced. publicly
declare to be wrong or evil
- Akin. of similar nature or
character
- Espouse. adopt
or support (a cause, belief, or way of life)
- Traction. the
extent to which a product, idea, etc., gains popularity or acceptance
- Quash. reject
or void, especially by legal procedure
- Quagmire. a soft boggy area of
land that gives way underfoot
- Assertion. a
confident and forceful statement of fact or belief
- Germinated. of a seed or spore) begin to grow and put out shoots
after a period of dormancy
- Philanthropist. a person who seeks to promote the welfare of others,
especially by the generous donation of money to good causes
- Ethos. the
characteristic spirit of a culture, era, or community as manifested in its
beliefs and aspirations
- Fraught. (of
a situation or course of action) filled with or likely to result in
(something undesirable)
- Prudish. having
or revealing a tendency to be easily shocked by matters relating to sex or
nudity; excessively concerned with sexual propriety
- Horde. a
large group of people
- Shooed. make
(a person or animal) go away by waving one's arms at them, saying “shoo,”
or otherwise acting in a discouraging manner
- Explicit. stated
clearly and in detail, leaving no room for confusion or doubt
- Innocuous. not
harmful or offensive
- Prose. written
or spoken language in its ordinary form, without metrical structure
- Incontinence. lack of voluntary control over urination or defecation
- Horrendous. extremely unpleasant, horrifying, or terrible
- Palliative. (of a medicine or form of medical care) relieving
symptoms without dealing with the cause of the condition
- Magnum opus. a large and important work of art, music, or
literature, especially one regarded as the most important work of an
artist or writer.
- Synthesis. the combination of
ideas to form a theory or system. Often contrasted with analysis
Summary
- Honour killings are a serious problem in Pakistan
and other parts of South Asia.
- They are often committed by family members against
women who marry without their consent or refuse to marry someone of their
choosing.
- This practice is rooted in feudal and patriarchal
mindsets that view women as property and second-class citizens.
- There is no honour in killing women for exercising
their free will.
- Islam grants equal rights to men and women to marry of
their own choice.
- Honour killings are a violation of Islamic principles
and basic human rights.
- More needs to be done to raise awareness about
honour killings and to bring about a change in attitudes.
- Public figures, such as filmmakers and celebrities,
can play an important role in speaking out against this practice.
- Education and awareness campaigns are also needed to
challenge harmful stereotypes and promote gender equality.
- Pakistan needs to take steps to protect women from
honour killings and to ensure that they are treated as equals in society.
- This is essential for the country's progress and
development.
- Women must be respected, loved, and given the
opportunity to play a significant role in all aspects of Pakistani life.
Article
Where did the term ‘honour killing’
come from? What is so honourable about conspiring to kill a female family
member if she chooses to marry of her own free will? How long will women have
to suffer this fate at the hands of the menfolk in their family or
community?
A recent article in Dawn discussed another statistic in the
mounting data of honour killings at home and abroad – an immigrant Pakistani
family settled in Italy killed their daughter because she refused to marry a
Pakistani boy of their choice back home. Instead, she wanted to spend the rest
of her life with her Italian boyfriend.
Filmmaker Sharmeen Obaid-Chinoy won an Oscar for her documentary
on honour killings, A Girl in the River: The Price of Forgiveness. She was
lauded by the international community for being courageous enough to highlight
a problem that has plagued this part of the world for aeons. If argued
religiously, Islam is very vocal on the subject and grants equal rights to men
and women to marry of their own choice. Then why are women treated as children
of a lesser God? Is family honour solely their responsibility?
A recent television serial, Razia, also dealt with the treatment
of females as second-class citizens, and touched upon the curse of honour
killing as Razia’s brother and father, suspicious about her involvement with
someone, conspire to kill her.
Public figures
should criticise honour killings vehemently.
However, destiny intervenes and she escapes unscathed.
The play, starring Mahira Khan, was extremely well-made and highlighted
irrational and twisted attitudes of society without any overblown drama. The
six-episode production was a laudable endeavour in the way in which it
addressed so many social issues crisply, without a long-drawn-out narrative.
Feudal mindsets and misogynistic attitudes are largely to
blame for the proliferation of this crime.
Historically, and even in contemporary times, women in feudal
setups are expected to relinquish their share of the property
voluntarily and those who resist are ostracised and vilified by
the community. This mindset is particularly entrenched in southern Punjab where
females are sometimes wedded to the Quran in order to keep property within the
family.
Ironically, while we are being encouraged to embrace the ways of
the 21st century, our regressive and patriarchal society is bent
on pushing us into medieval times. The article about the honour killing in
Italy validates this dichotomy. Despite living in the Western world, the
primitive and bigoted outlook of some South Asians there is too deeply
embedded to be uprooted easily.
Education, although it will alleviate the issue to a
certain extent, is not the solution. Awareness and a conscious effort to bring
about a shift in this way of thinking will serve as the magic bullet for the menace.
As long as women are treated as second-class citizens and the ingrained hatred
towards them remains deep-seated in our societal fabric, not a lot, I am
afraid, can be achieved.
Endeavours like Ms Chinoy’s documentary on the issue are steps
in the right direction. She was accused of giving her country a bad name on a
global platform but at least she had the courage to depict realities which very
few have the courage to even speak about. Honour killings, in any part of the
world, should be denounced and condemned repeatedly and the documentary
is only a drop in the ocean.
Attempting to bring about change is akin to attempting
the impossible. However, small steps go a long way so even a dent is an
achievement. More celebrities and public figures should espouse this
cause and criticise the primitive and barbaric practice more vehemently. I am
quite sure that plays and films on the subject will draw significant attention
to the medieval ‘ritual’ that is gaining traction, rather than being
curbed and controlled.
Pakistan is already viewed as a failed state where it has been
proved time and again that women, comprising 51 per cent of the population,
inevitably get the short end of the stick. Women must be respected, loved and
treated as equals. The founder of this nation, Quaid-i-Azam Mohammad Ali
Jinnah, made it abundantly clear that for this country to prosper and march
ahead, the women have to play a significant role.
And increasingly, as they emerge as a force to be reckoned with,
women are becoming hard to ignore and their voices and identities tough to quash.
At a time when Pakistan is sinking into a political and economic quagmire
and struggles to stay afloat, we need enlightened, educated and strong women to
become a pivotal part of rehabilitative endeavours.
Summary
- Gilgit-Baltistan (GB) is a
region with a disputed legal status.
- It is not officially part of
Pakistan, but is under Pakistan's control.
- This has
led to a lack of representation for GB in Pakistan's parliament and
limited empowerment for local governments.
- GB is rich in resources but
faces energy deprivation and neglect.
- The region has substantial
mineral resources and hydropower potential, but its infrastructure
development is focused on meeting the needs of Pakistan.
- A
top-heavy governance structure consumes most of GB's limited budget,
leaving little for social welfare programs.
- GB's people are resilient and
have a strong sense of community.
- They have a history of
confronting harsh conditions and enduring limited resources.
- GB's
diaspora communities maintain strong ties with their homeland.
- NGOs have played a key role in
supporting GB's development.
- The Aga Khan Foundation's
Rural Support Programme has been a major success, providing education,
healthcare, and other essential services.
- The
Marafie Foundation has also been instrumental in promoting education and
healthcare, particularly for girls and women.
- GB is pioneering a novel
approach to social protection.
- The government of GB has
launched a Social Protection Fund (SPF) to address poverty and inequality
in the region.
- The SPF
is modeled after an Initial Public Offering (IPO), inviting the public to
invest in social welfare programs.
- This
approach aims to create a sustainable financial base for social
protection and to empower communities.
- The SPF is a call to action
for social justice and equity.
- It is an opportunity for
individuals, businesses, and organizations to invest in the future of GB
and its people.
- The SPF
represents a commitment to the idea that everyone deserves the
opportunity to thrive.
Article
Every November, the people of
Gilgit-Baltistan commemorate their freedom and accession to Pakistan. The
Pakistani state actively promotes the region as the most beautiful part of the
country, highlighting its unique and breathtaking landscape to encourage tourism.
However, when a student from Gilgit-Baltistan questions the
denial of constitutional rights and the territory’s undefined legal status in
conversation with the prime minister, the PM simply responds with the assertion
that Gilgit-Baltistan is an integral part of Pakistan and will continue to be
so.
Despite possessing substantial mineral resources and the
potential for hydropower energy, the region suffers from energy deprivation due
to this imposed control. The development of infrastructure is solely focused on
meeting the strategic needs of the federation. A top-heavy governance structure
consumes most of its limited budget grants, exacerbating the neglect.
Amidst the prevailing gloom and adversity, the resilience of the
people of Gilgit-Baltistan is a silver lining. They continue to exhibit a
unique ability to confront the harshest forces of nature and endure punishing
winters with their limited resources. GB’s diaspora communities not only thrive
outside the region but consistently return, highlighting their unwavering bond
with their homeland.
The remarkable
resilience of Gilgit-Baltistan’s people finds support in the NGO sector.
The remarkable resilience of these people, despite the denial of
essential resources, finds support in the NGO sector. Over the past four
decades, the Rural Support Programme initiated by the Aga Khan Foundation has
emerged as a success story.
Additionally, the Marafie family-funded NGO has played a pivotal
role in the development of education, particularly for girls, and healthcare
services, predominantly in the Baltistan division. Its impact has now expanded
to encompass the entire region. The Marafie Foundation’s success is attributed
to the active participation of the local community village and women groups
organised by the Agha Khan Foundation, signifying a collaborative effort in
promoting education and healthcare in the region.
The community’s notable achievements, facilitated by the support
of these two NGOs, have served as a catalyst for the emergence of numerous NGOs
initiated by the locals and comprised mostly of well-informed, educated youth.
This trend ensures sustained grassroots development of community
projects, promising macroeconomic development for the region despite years of
governmental neglect. This same spirit propels GB to explore innovative avenues
for poverty alleviation.
Under social pressure from vocal and assertive local community
organisations, GB has now embarked on a new and novel scheme for social
protection for the vulnerable segments of society and the community at large.
As we well know, the concept of an IPO comes from the corporate
world, where companies invite the public to buy equity shares in their future
profits. However, through its novel approach, the GB government is proposing
investments in human capital, social resilience, and the very fabric of our
society, which may one day be found relevant to the whole of Pakistan.
The SPF is designed to address the systemic challenges of
poverty and inequality in GB by providing a sustainable financial base for
social protection programmes. The GB government agreed to seed this initiative
with Rs100 million, demonstrating a strong commitment to social protection.
Since this idea was germinated through an interactive process with
Unicef, it may also consider contributing to the SPF as a pilot. SPF will
eventually be linked with a provincial Social Registry.
The SPF IPO is an open invitation to every citizen, business, philanthropist,
and international development partner to take a stake in the future of this
region’s social welfare. Why is this important?
The SPF will stabilise social welfare funding, protecting it
from political shifts and economic downturns. It will ensure that essential
services — from childcare to education and emergency support — will always be
available to those in need. Moreover, it will empower communities by providing
the means for sustainable development, breaking the cycle of poverty and
dependence.
But the SPF will do more than just provide services; it will
engender a new philosophy of social welfare that is participatory, inclusive,
and democratic. By buying into the SPF, investors are not just providing funds;
they are taking ownership of the mission to protect and empower the most
vulnerable members of society.
The SPF aims to leverage the spirit of public ownership to
create a fund that is accountable to its stakeholders — the people. This is a
call to action for all who share a commitment to social justice and equity.
This call to action resonates with the ethos of social
justice and equity. It is an appeal to every individual and organisation that
aligns with these values to join hands in this pivotal movement.
The SPF is not just a fund; it is a commitment to the idea that
every individual deserves the opportunity to thrive — and that through
collective investment, we can make this vision a reality for GB.
Summary
- Dr. Tahira Kazmi, a
gynecologist, is a pioneer in addressing female sexuality in the context
of Pakistan's conservative environment.
- She has faced criticism for
her explicit blogs but has also garnered admiration for enlightening
women about their bodies.
- Dr.
Tahira describes herself as a 'Gynae-Feminist' and has authored multiple
collections of blogs covering various women's health topics.
- Her
writings discuss childbirth, labor pain, menstruation, menopause,
incontinence, and prejudice against the girl child, bringing these issues
into the public space.
- Dr.
Tahira highlights shocking crimes against women, such as the practice of
putting a lock on a woman's vagina to control her fidelity.
- She
emphasizes the need to challenge traditional views that attach shame to
women's reproductive organs, advocating for a more open and accepting
discourse.
- The blogs
originated from personal experiences, with Dr. Tahira turning to
gynecology blogging in 2021 after witnessing her daughter's severe
menstrual agony.
- Tahira
criticizes the societal misogyny in Pakistan, pointing out the lack of
outrage over crimes against women and the prevalent distortion that needs
correction.
Article
The women’s movement in Pakistan has
come a long way since its inception. It has assumed different forms and
strategies during the course of its development while focusing on the
fundamental human rights of women and their empowerment. What was noticeably missing
was the female sexuality dimension in the discourse. It was too sensitive an
issue to talk about in public in Pakistan’s conservative environment that was fraught
with controversies.
Ours is a society that is so prudish that an article I
wrote on breast cancer in 1978 had prompted a horde of bearded gentlemen
claiming to be the guardians of our morality to crash into the editor’s office
to denounce the fahaashi (vulgarity) the paper was publishing. Being
progressive and a feminist himself, the editor had shooed them away
saying that breast cancer was a life or death issue for women.
In such a society, it needs guts to write about the female
reproductive organs in explicit terms. There are far too many readers
whose thinking is misogynistic and patriarchal. Even an innocuous
piece of writing becomes pornography for them. Their anger stems from the
belief that women are sex objects created to give satisfaction to man’s
desires.
That would explain why Dr Tahira Kazmi’s blogs on the social
media have invited the wrath of her critics who are in abundance. Mercifully,
the doctor, a gynaecologist by profession, also has admirers. She has brought
enlightenment to many female readers who feel after reading her blogs that they
understand their bodies better. Being highly qualified — MBBS from Fatima
Jinnah Medical University Lahore (1990) followed by a train of higher foreign
degrees — Dr Tahira knows what she is writing. She holds prestigious positions
in Oman’s Ministry of Health and the Sultan Qaboos University.
Our society’s
misogyny is sickening.
Four collections of her blogs have already appeared while the
fifth is under publication. A fair-minded reader would take them as a
scientific piece of prose written in the social context with a strong
underpinning of feminism. She describes herself as a ‘Gynae-Feminist’.
All the subjects covered are familiar to women reading
English-language newspapers but no one has written on them in Urdu so frankly.
Childbirth, labour pain, menstruation, menopause, incontinence and
prejudice against the girl child have been covered in different social
contexts. If the frankness is shocking it is because these issues have been
kept under wraps. It is time they were brought into the public space to make
them socially acceptable.
But what will continue to shock are the horrendous crimes
against women Dr Tahira exposes. How else would one describe the practice of
putting a lock on a woman’s vagina with the key kept in the husband’s pocket
for safekeeping to ensure that the wife is not unfaithful to him.
It is the feminist in Tahira that is most striking. She is quick
to note an injustice done to a woman. She recalls how observant and curious she
was as a child and still is. “You have to convince me with solid arguments if
you think I am wrong. If you force me I will hit back. I am not afraid of what
people say,” she says boldly. She also has the discretion to know when silence
is a befitting way to snub an obnoxious critic.
Her greatest assets have been her medical knowledge and her
writing skills that helped her produce blogs with literary elegance. It was
motherhood that led her on the road to self-discovery of her latent talent. She
wrote her first blog on the night of her mother’s death. She was suffering from
Alzheimer’s. Grief drove Tahira to write, “I saw my mother melt drop by drop”
and the blog went viral. That was 2019. She turned to gynae blogging in 2021
when she saw her daughter in severe menstrual agony. It prompted her to write
to explain how the female anatomy makes pain a handicap for a woman needing
male understanding. Pain also makes a person creative, with reference to Faiz’s
verse on his heart attack and the pain he suffered, Tahira wrote, “Kash Faiz ko
mahwari aati”.
What angers Tahira is the traditional view that women carry the
honour of the family — meaning the man’s. Hence shame is attached to the
woman’s reproductive organs that are given derogatory names. Why can’t the
spade be called a spade one may ask.
Our society’s misogyny is sickening. Pakistan is a place where
men fight and attack each others’ women to take revenge. Where were these
critics when women were paraded naked in the streets of Nawabpur (1984) and
when Mukhtaran Mai was gang-raped on the orders of a male jirga (2002)?
Presently, 30,000 girls are trafficked every year to be sold into prostitution
to satisfy men’s lust and not a voice is raised. It is this distortion the good
doctor blogger is trying to correct.
Summary
- Healthcare systems have 3 main roles: preventing
diseases, providing curative services, and addressing health determinants.
- They deliver 5 kinds of services: preventive,
promotive, curative, rehabilitative, and palliative.
- These services are delivered at 5 levels: community,
primary healthcare facility, first-level hospital, tertiary-level
hospital, and population.
- In low-resource settings, policymakers must
prioritize services to ensure the most efficient use of resources.
- Disease Control Priorities (DCP) is a project
that identifies cost-effective health interventions for low- and
middle-income countries.
- DCP3 recommends a package of 218 essential health
services, with a prioritized subset of 108 services for low-resource
settings.
- 70% of these services should be delivered at the
primary healthcare level, and 90% at primary healthcare or first-level
hospitals.
- Governments should finance this minimum package
of essential health services.
- Pakistan has developed its own Essential Health
Services Package (EHSP) based on DCP3, costing around $13 per person
annually.
- Effective implementation of EHSPs can advance
countries towards universal health coverage.
Article
I received a lot of feedback on my
article ‘Robotic priorities’, including some from
defensive robotic surgeons! Some readers have asked about the essential health
services package I referred to. Allow me to elaborate.
Healthcare systems principally act in three ways: by
preventing diseases and promoting health at population and individual levels;
by providing curative health services at an individual level; and through
intersectoral action addressing determinants of health.
Healthcare systems deliver various combinations of these five
kinds of services through five levels of the healthcare system (also called
delivery platforms): community level (individual household); first-level
PHC facility; first-level hospital; tertiary-level hospital;
and population level (eg awareness-raising media campaigns).
With this conceptualisation, in low-resource settings,
policymakers must make difficult choices. The right health services must be
selected for the right levels to ensure the most efficient and effective use of
limited resources to maximally benefit the people. Appropriately addressing the
burden of various diseases and health risks is key. From here we enter the
realm of “disease control priorities (DCP).”
The principle
of prioritising health services applies to all healthcare organisations.
A story spanning 30 years, beginning with DCP1, which fed the
World Bank annual flagship development report themed Investing in Health in
1993. It was the first time a proper attempt was made to assess the value for
money (cost-effectiveness) of health interventions that would address the major
sources of disease burden in low- and middle-income countries (L&MICs).
DCP3 took more than five years of analysis involving more than
500 leading global medical experts and 33 editors who produced 172 chapters in
nine volumes on health services related to: Essential Surgery (Vol 1);
Reproductive, Maternal, Newborn and Child Health (Vol 2); Cancer (Vol 3);
Mental, Neurological, and Substance Abuse Disorder (Vol 4); Cardiovascular,
Respiratory, and Related Disorders (Vol 5); Major Infectious Diseases (Vol 6);
Injury Prevention and Environmental Health (Vol 7); Child and Adolescent Health
and Development (Vol 8); and Disease Control Priorities: Improving Health and
Reducing Poverty (Vol 9).
This work is a magnum opus on health services — an
evidence-based descriptive analysis of the situation in L&MICs, detailing
why and which proven cost-effective health services should be provided as a
priority. DCP-3.org makes all these volumes freely available.
The ninth volume is a synthesis of the preceding eight.
The basic idea is that if countries must achieve universal health care (UHC) by
2030, which health services should be provided to the people. Health services
are costed and classified in 21 groups. Systematically sifting and selecting
through the maze, DCP3 ultimately proposes a package of only 218 essential
health services. If resources are too low then a highly prioritised sub-set
package of 108 services is recommended. It was estimated that to provide these
packages to a whole population, governments would have to double or triple
their current level of health financing.
The principle of health service prioritisation however, applies
to all healthcare organisations. I have noticed that most well-meaning service
oriented not-for-profit organisations don’t bother to systematically invest in
developing their health services package. This is the centrepiece of
healthcare, and once defined, guides everything from human resource needs and
training, financing, medicines and diagnostics etc.
The translational phase of this work is L&MICs developing
their own packages using DCP3 as a model. As part of UHC-related assistance,
WHO has been urging the development of national packages of essential services.
As Director of Health System Development in WHO EMRO, I started promoting this
idea to Pakistan. Eventually, with the help of DCP3, WHO, BMGF, AKU, HSA and
some other partners we started developing the National EHSP.
When I assumed the office of Special Assistant to the Prime
Minister, I made this a priority and finally we became the first country to
systematically develop an EHSP following DCP3 and even got it costed. I had a
wonderful team of young researchers at the Health Planning, System
Strengthening, and Information Analysis Unit (HPSIU) in the ministry who
managed this work.
Pakistan EHSP was launched in October 2020. It is the result of
wide-ranging national consultations with health specialists in the country from
public and private sectors. Our analysis showed that only 42 — ie less than
one-fifth of the 218 interventions — were available in Pakistan’s public sector
facilities, and these gaps were pronounced at the PHC level.
HPSIU has since worked with provincial health departments and
today all provinces have developed their own packages with minor differences.
All of these are available online under ‘Knowledge Hub’ on the Ministry of
National Health Services, Regulation and Coordination website.
Effective implementation of these packages would effectively
advance Pakistan towards universal health coverage.
More on intersectoral service packages next time.
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