The Shirkat Gah-Women’s Resource Centre organised a dialogue with media personnel on Wednesday morning to brief them on the current scenario vis-à-vis reproductive health and women’s rights in Pakistan.
Shirkat Gah has conducted various researches and advocacy projects pertaining to women’s empowerment, violence against women and women’s health and rights.
A large component of this work has been on reproductive health and the scenario has been explored in both rural and urban settings. Various issues have come to the fore ranging from lack of access to health facilities, non-functional Basic Health Units (BHUs), and lack of training of mid-level service providers such as Traditional Birth Attendants (TBAs), commonly known as ‘dais.’
Health, it was explained, was not just the absence of disease and infirmity but a state of complete physical, emotional and mental well-being. Reproductive health similarly espouses the ability of individuals to choose, when, how, and how often to reproduce. Health was often looked at only from a service delivery point of view, not in terms of rights of individuals or the responsibilities of the state.
A documentary called “Mumtaz Bach Sakti Thi” was also shown on the occasion. It was about a woman who died during the delivery of her fourth child due to extreme high blood pressure. Mumtaz was a very active member of her community. When she needed to see a doctor during her pregnancy she was told she could not go to one without a male relative. The documentary covers her tragic story as well as the views of doctors. These doctors have said that she was just one woman of countless who suffered this problem. High blood pressure and anaemia have been very common reasons for maternal mortality. The participants were told that anaemia affects about 60 per cent of women and girls across the country and it was a major reason for maternal mortality.
Media personnel were told anemia was not an incorrigible problem since the BHUs had sufficient stock of iron supplements but women were not taking them.
The respondents of the documentary said that what was needed was monitoring systems and checks and balances on the various medical service providers available. Common myths were also addressed, for one, that a caesarian operation does not have adverse effects on a woman’s health if performed in a safe environment; so long as she does not engage in exertion soon after the delivery. One doctor says that women victims of violence have poor health, their children’s health suffers and they were more likely to die at childbirth due to anaemia, high blood pressure etc.
Skirkat Gah representative Tabinda Fafay Saroosh, after screening the documentary, explained that unfortunately when women like Mumtaz die at childbirth, it was dismissed as a matter of fate which was tragic because such deaths were entirely preventable.
Saroosh said two very important indicators for any country’s progress were its Maternal Mortality Ratio (MMR) and Infant Mortality Rate (MR). She pointed out that Pakistan had the highest rate in South Asia in both cases. She said for improving these indicators what was needed was a Continuum of Care of women’s health, i.e. continuous care throughout different stages of a woman’s life. Young girls were not given proper nutrition, they became physically weak, suffered from anaemia, and then they were married early with consequent early pregnancies. She pointed out that adolescents found it difficult to discuss their reproductive health with anyone which led them to make making poor reproductive choices. She said ideal age for reproduction was after 18 for both sexes. Before the age of 18, a young girl’s physique was not ready to bear the burden of childbirth. In fact the pelvic bone was growing even between the ages of 21-24, Saroosh, also a medical doctor, said. So even that age she was very young.
Saroosh said when women do reach the ideal reproductive age, family planning was very important. She pointed out that Pakistan has a very low contraceptive prevalence rate and was currently the sixth most populous country in the world. Women’s health was also severely neglected in their old age, she added.
Saroosh said Pakistan was also a signatory to many international commitments, through which it was bound to respect reproductive health and rights. The Convention on Elimination of All Forms of Discrimination against Women (CEDAW), the Convention on the Rights of the Child (CRC), and the Millennium Declaration calls for action on eight Millennium Development Goals (MGDs). She said MGD 5,(a) and (b), were related to reducing maternal mortality and universal access to reproductive health. She said there was also the International Conference on Population and Development (ICPD) at which the country’s first female premier slain Benazir Bhutto remarked that she dreamed of a Pakistan where every birth should be wanted and every child should receive the nurture and support it deserves.
Media personnel actively participated in the interactive discussion after the presentation of Dr Saroosh.