hen we first visited Balochistan’s Lasbela district in October 2022 and began providing mental health counselling to victims of gender-based violence, which had dramatically increased following the 2022 flood, we met with several challenges. People considered mental health problems a taboo and felt ashamed to talk about those with an ‘outsider.’ Moreover, gender-based violence was perceived as a ‘normal’ occurrence. I also faced resistance initially from some local clerics and tribal elders who were unhappy with our work, as they viewed domestic violence and use of harsh words as routine. Many people hesitated to talk about it and would rather suffer alone. The Lasbela district, with a population of almost 0.5 million, was severely affected by the 2022 flood. Approximately 43 per cent of its population was impacted and a third of the district was submerged in floodwater.

Lasbela saw an uptick in both physical and verbal abuse against women following the 2022 flood. This pattern was no different from Nasirabad, Jhal Magsi and Dera Murad Jamali districts, which were also affected by the 2022 flood.

The challenges facing women in Balochistan are enormous. These include honour killings, economic disparities, denial of rights and deeply ingrained patriarchal attitudes. Societal norms and cultural expectations compound the challenges faced by these women.

Deep-rooted patriarchal attitudes and traditional gender roles significantly limit women’s independence in Balochistan. Cultural and religious barriers restrict their access to education and better economic opportunities for becoming more independent. This is why women are more marginalised in the Baloch and Pashtun societies in Balochistan.

Issues such as domestic abuse and honour killings, locally known as Siyakari or “black deeds,” are deeply entrenched in the cultural and social tapestry of Balochistan. According to Aurat Foundation, 66 women were killed in the name of honour in Balochistan in 2022. Unfortunately, a majority of these crimes go unreported. A key reason for this is the cultural stigma attached to acknowledging such violence.

In Lasbela, while working as a psychologist, I observed that verbal abuse was so normalised and blended in women’s daily lives that many women no longer considered it an issue.

The surge in violence did not only compromise women’s physical health but also created a huge mental health crisis, with PTSD, depression, anxiety and suicides among young people becoming more frequent.

When we began raising awareness in Lasbela about mental health and domestic violence, there was some initial resistance. However, PPHI Balochistan’s and UNFPA’s support helped us address these issues. We opened a number of Women-Friendly Spaces at Basic Health Units in Lasbela. These spaces provided a platform for women to come together, talk and allow their children to play. Besides that, we distributed thousands of hygiene dignity kits among poor and vulnerable women. Providing dignity kits and establishing women-friendly spaces proved very helpful in attracting more people and, thus, raising awareness among them about mental health and domestic violence and its impact on children’s mental well-being.

Early on we noticed that rather than seeking mental health support, a majority of the people in the district used to turn to religious clerics. In severe cases, individuals were taken to them daily. Some families did not mind travelling hundreds of miles in search of a cure.

Addressing complex issues such as domestic violence, honour killing and the significant mental health crisis in Balochistan demands time and effective policies. Factors like climate change, militancy, poverty and natural disasters exacerbate these challenges.

One day, in one of the remote localities of Lasblea, I came across a woman named Ayesha Bibi, in her sixties, whose daughter, Gulnaz, was suffering from intense stress. Bibi, a widow, spent a considerable sum of money to provide a 40-day treatment to Gulnaz. The cleric explained to the family that djinns and spirits were the reason behind Gulnaz’s poor health. To drive away the djinn from Gulnaz’s soul he suggested a 40-day treatment. The family paid more than Rs 200,000 to the man. During the forty-day treatment, Gulnaz was chained and beaten with a stick.

During our conversation we learnt that she was severely depressed because her husband had become harsh and violent after losing his income and livestock in the flood.

Gulnaz said that when she felt the cleric’s ‘treatment’ was causing her more depression, she kept calm to pretend that she had recovered. In fact, she was suffering from severe depression and anxiety because of her husband’s behaviour.

We met with Gulnaz a couple of times and provided her with mental health counseling. This helped her immensely. However, her mother was unhappy with my interaction with Gulnaz. One day, she said that I should stop meeting her daughter, as it was interfering with the cleric’s treatment plan.

When we tried to expand the reach of our awareness campaign against domestic violence, a local cleric told me to stop it, calling it a Western-backed agenda.

With the help and support of the district administration and some tribal elders, we managed to eliminate the stigma surrounding mental health and domestic violence. A year after I had started working, I realised that some local women were joining me in raising awareness about domestic violence and mental health. Some of them had initially told me that getting scolded and staying calm was a sign of a smooth relationship.

Among the women who joined me last year when we marked 16 days of activism in Lasbela to raise awareness on various issues, two were Shakar Jan and Adeela. Initially, their mother would not allow them to visit our office. However, when I left the PPHI in February, I found the two sisters and their mother sitting in the PPHI women-friendly space every day, stretching clothes, playing and reading. On the day I was leaving, the twin sisters hugged me and cried. Their mother gave me a bottle wrapped in cloth. When I opened it at home, I found that it was honey, a goodwill gesture. The poor woman is raising her children all by herself as her husband is a drug addict and abusive.

Also during the 16 days of activism, we found Gulnaz, her mother, and her husband. She hugged me and kissed my hands. Her husband and her mother thanked me. I consider this my most significant achievement in two years.

On behalf of the PPHI Balochistan and the UNFPA, we worked tirelessly for nearly two years in Lasbela. When the project ended, I had to return to my home, leaving behind thousands of women and children vulnerable to domestic violence and mental health issues. I believe that longer durations are necessary for such projects. In conservative environments like Balochistan, where gender-based violence is normalised and mental health is often regarded as a spiritual ailment, more time is required to combat these deeply ingrained issues effectively.

Addressing complex issues such as domestic violence, honour killing and the significant mental health crisis in Balochistan demands time and effective policies. Factors like climate change, militancy, poverty and natural disasters exacerbate these challenges. This requires more time, legal reforms, enhanced mental health education and a cultural transformation.

The provincial government and the NGOs must invest more time, resources and energy into creating a more equitable and inclusive society for women and children in Balochistan.

*Names have been changed to protect identities

The writer is a psychologist