Roses against hate and terror
Oslo killings brings to light extremism threats faced by multicultural West
By Toni Usman
The Muslim community in Norway was tense and scared after right wing extremist Anders Behring Breivik detonated a bomb on July 22, 2011 outside the Norwegian prime minister’s office and went on a shooting spree in Oslo killing 77 people. The Muslim community thought some Muslims might be behind the atrocities and feared retaliation from the Norwegian society.
General Secretary of the Islamic Counsel, Mehtab Afsar, tells TNS that before the terrorist was arrested, he was asked by several journalists if he could justify terrorism, implying that some Muslims are behind the violence. Before it was clear who was responsible for the terror acts, Prime Minister Jens Stoltenberg declared in his address to the nation that “our openness has been attacked and our answer to this will be more democracy and more openness”. As a result of his words, the society displayed its feelings by placing roses in the streets.

Yeh Woh
DIY and spread
happiness
By Masud Alam
Ramzan is an exceptional time: There’s exception to work, exception to play, exception to rules and regulations et al. The only business as usual in this month of blessings is the wholesale killing of human beings that used to be a specialty of Karachi but is now being practiced in Quetta too.
Life is easy for the white collar employee whose working hours are cut in half during Ramzan. And the afterlife seems rosy too, if they are fasting. As a rule, pretty much every one working out of the comfort of air-conditioned environment has their working hours slashed. Even the British bank closes its doors on customers at midday. The reduced hours are not compensated by opening more counters, and so the result is gross overcrowding on a daily basis.

health
Burning issue
After all that has happened, Peshawar still has no adequate facility to treat burn victims who are sent as far as Wah Cantt and Kharian
By Mushtaq Yusufzai
Hundreds of people have lost their lives and thousands of others have been injured and physically handicapped in suicide attacks, bomb blasts and drone strikes in Khyber-Pakhtunkhwa.
Sadly, a healthcare system that can effectively react to emergencies is miserably missing in the area: Take burn injuries — majority of the burn victims are referred to Wah Cantonment, where the Pakistan Ordnance Factory has set up a well-equipped burn care centre, or to the Pakistan Army-run burn centre at Kharian. According to officials, only five beds are reserved for the civilian burn patients in Wah from all over Pakistan, and those five beds are always occupied.

Cancerous concerns
Acceptance and looking for solutions is the key to stem rising cervical cancer in Pakistan
By Farah Zahidi Moazzam
Cervical cancer is a growing cancer in Pakistan. It is one of the few cancers that are contracted, in more than one ways. It is, however, more often than not, contracted through unprotected sexual contact with a carrier. The human papillomavirus (HPV), a sexually transmitted infection (STI), in its various strains, is what mostly causes cervical cancer. Thus, a sexually active woman is at risk of contracting the virus. Married or not.
Often the carrier, if a man, will not be affected by the virus himself, but will transmit it to the woman. The vaccine that protects against it, though still being studied upon, is available in Pakistan. Expensive, yes, but potentially life-saving. The best time for a girl to get the vaccine is before the years she becomes sexually active. Hence, teenage years are a good time to get vaccinated against HPV. But in Pakistan, we see a resistance to the idea of getting teenage girls getting this vaccine.

Parenting or paranoia?
Parents and children have opposing views when it comes
to the use of internet
By Anam Javed
Most parents today reminisce about their carefree childhoods — frolicking around with friends, visiting neighbours and indulging in harmless mischief… all without their parents constantly keeping tabs on them.
Today the world has changed. Parents hesitate before letting their child walk to the next block. The thought of all kinds of people with dubious intentions interacting with their children is their ultimate nightmare.
And this nightmare has invaded the cyber world as well. This generation was forced to take refuge in front of their game consoles and laptop screens. But most parents now feel that children are no safer in front of these screens than they are out on the open roads.

 

tourism
Swat gets a new life

A luxurious black jeep cruising on the winding road slowly comes to a halt, right next to a young Pashtun policeman whose gestures the driver understands very well. He peeps into the vehicle through the window and utters some words to the driver in Pashtu. The driver replies in the same language, and after an exchange of niceties, hands him his national identity card.

The cop casts a look at the card with disdain, asks the driver to park the car on the roadside and walks towards an army official sitting in a makeshift office structure. He hands over the card to the official who picks up a register, turns leaf after leaf and finally starts making the entry. This show of civil-military liaison in maintaining security at pickets is reflective of how rehabilitation process is going on in the area.

The whole process may take from one to ten minutes to complete. It gives an impression of being secure in this land of majestic scenic beauty — Swat.

Security checks are frequent in the jurisdictional boundary of the valley. While visitors may view this as a nuisance, the locals who have survived the militants’ rule take these security pickets as a blessing.

It was not only the militancy and the military operation against them, ending in 2009, that took a heavy toll on the people of Swat. The floods of 2010 added to their miseries as it washed away whatever little they possessed.

A year down the road, the valley of Swat is still struggling to recover and its people yearning for the prosperity and tranquility synonymous with its name. A visit to the place reveals that besides other factors it is the perception of fear that keeps people away from coming here. This very fear of insecurity hampers the pace of reconstruction and rehabilitation in the valley as private contractors shy away from entering the area. Due to this fear, military is involved in almost every ongoing rehabilitation effort in the valley.

I visited Swat a fortnight ago and observed the roads, bridges, water supply schemes and irrigation channels being repaired at a brisk pace. I could spot endless signboards of NGOs, donor agencies, government organisations etc erected along the roads throughout the valley. The ongoing projects ranged from construction of public toilets and crop improvement schemes to setting up of schools, plantation drives — and what not. The emphasis, however, was mainly on preparing Swat for local tourists for the peak season that starts in fall.

Muhammad Khursheed, 45, a resident of Mingora who runs a rent-a-car business there, says a large number of NGOs and donor agencies are operational in Swat but, unlike in the past, this time they are directed by the Provincial Reconstruction, Rehabilitation and Settlement Authority (PaRRSA) — a body working under the Khyber-Pakhtunkhwa government. Khursheed, whose vehicles are routinely hired by these organisations, adds that PaRRSA guides the intending NGOs to direct funds where they are most needed — “The authority works in collaboration with the Provincial Disaster Management Authority (PDMA) and facilities all the other parties involved.”

Khursheed thinks the people of Swat are as peace-loving and friendly as ever, but are now reluctant to talk to strangers. “The trauma of the insurgency and floods are still fresh in their minds. They doubt the identity of any new person who comes into contact with them. They suspect him to be an agent of security forces or Taliban. The rehabilitation of Swat will not be complete until its people overcome the trauma.”

The rehabilitation of Swat cannot be complete without reviving the tourism industry. The task of reviving the hotel industry and trout fish farms has been initiated by USAID. “The agency has conducted a comprehensive survey of hotels affected during the militancy and floods and short-listed 239 hotels under different categories,” says Aftab-ur-Rehman Rana, the USAID’s consultant on tourism, adding: “These hotels are being paid in cash and kind and also helped to prepare workforce as many of them have migrated to other parts of the country.”

Trout is another attraction of Swat. Therefore, says Rana, 18 trout fish farms were provided seed and imported feed to come out of the crisis they were facing. “Trout fish farm owners had to leave their farms during the operation. Efforts were made to resettle them, but the floods ruined all these plans and destroyed the structures overnight.”

The locals recall trout fish selling huts were located at short distances along the road from Bahrain to Kalam and tourists would swarm there to have a bite of this tasty fish. “They are nowhere in sight,” regrets Muhammad Rasheed, co-owner of New Spring Trout Fish Farm. Rasheed says that fish farmers used to sell 3000 kg of trout fish every year and earn handsome revenue. “But now we do not have a single fish ready for sale. The fish in the farm is too small. It’ll be ready in four months or so.”

Rasheed says the setting up of a fish feed plant can be of great help. “Fish stock of a trout farmer worth millions was killed when some miscreant put a poisonous chemical in his farm. The farm owner still doubts it was done on behest of a militant who wanted to take control of his farm.” He also urges the government to provide them quality fish feed as the imported one provided by the donors has run out.

While walking down the bazaars of Swat, I saw the handicraft and antique business is as badly affected by the present slump in the tourism sector. The souvenir shops of the past have been converted into go-downs where heaps of onion and potato bags are stored for Ramazan.

Syed Alauddin, PPP MNA from Swat, says the military and civilian government is working on reconstruction side-by-side. The problem is not with their capacity to work, but the shortage of funds. “I have asked the central government to release Rs320 million for my constituency so that the destroyed roads, bridges, water supply and irrigation schemes can be repaired immediately. Without putting infrastructure in place, rehabilitation is only a dream,” he adds.

During the three-day stay in Swat, I got the chance to interact with the few tourists. Generally they loved the setting and would like to come here again and again — if only the Malam Jabba hotel, the chairlift, and the roads are repaired. “The presence of security paraphernalia is a must, I agree, but it would be better if it’s invisible,” said one tourist.

shahzada.irfan@gmail.com

Roses against hate and terror

The Muslim community in Norway was tense and scared after right wing extremist Anders Behring Breivik detonated a bomb on July 22, 2011 outside the Norwegian prime minister’s office and went on a shooting spree in Oslo killing 77 people. The Muslim community thought some Muslims might be behind the atrocities and feared retaliation from the Norwegian society.

General Secretary of the Islamic Counsel, Mehtab Afsar, tells TNS that before the terrorist was arrested, he was asked by several journalists if he could justify terrorism, implying that some Muslims are behind the violence. Before it was clear who was responsible for the terror acts, Prime Minister Jens Stoltenberg declared in his address to the nation that “our openness has been attacked and our answer to this will be more democracy and more openness”. As a result of his words, the society displayed its feelings by placing roses in the streets.

One week after the atrocities, on Friday, July 29, 2011, the prime minister visited Norway’s largest mosque Central Jamaat Ahl-e-Sunnat to emphasise that he will continue to fight for a multicultural society. He delivered a speech right after the Juma prayers, saying the nation has passed the test.

Norwegian-Pakistani Shakil Ahmad Khan, who owns a restaurant nearby where the bomb detonated, says that in order to preserve the multicultural society they live in they must stand together and support each other.

Norwegian-Pakistani Hadia Tajik, Labour Party MP and member of the Education and Research Committee, has her office in the same building that houses the prime minister’s office. Luckily she was not in her office at the time the bomb detonated.

She writes in an article that “the terror changed Norway for ever but it is we, the people who decide the kind of changes. We must continue to work for peace, openness, solidarity, democracy and justice. We shall not only lead our nation in a dignified manner during a crisis, but we will also show the world the way to combat terrorism and hate with love.”

The impressive manner in which the government and the Norwegian people have tackled the situation gives the Pakistani community hope, hope for peace, hope for democracy, hope for love and hope for a tolerant multicultural society where all live in harmony.

Norway is one of the world’s richest and most peaceful countries. The country has a population of only 4.9 million and among them are 35,000 Pakistanis which is the country’s largest ethnic group. Pakistanis first came to the country at the end of the 1960s, though the largest group immigrated to Norway during the East Pakistan crisis.

In the beginning, these Pakistanis worked in factories, restaurants and did cleaning jobs. Nowadays many are solicitors, doctors, journalists, politicians, fashion designers, IT experts, taxi owners, researchers and artists. They contribute by strengthening the Norwegian economy and build Norwegian society and act as good ambassadors for Pakistan. PIA has direct flights between Norway and Pakistan.

Norway is an open, democratic and secure society, but from time to time this openness and peacefulness is challenged by right-wing extremists. Whenever there has been politically motivated violence on Norwegian soil it has been carried out by right-wing extremists. During the Second World War, right wing politician Vidkun Quisling collaborated with the Nazis. After the war was over and Norway was free from Hitler’s five year occupation, Quisling was given death sentence for betraying his country and the Constitution. That was the last death sentence passed in Norwegian history. Today, Norway does not have death sentence.

The extremists became active again in the 1970s. At that time their main target was the May 1 parade. They planted bombs on Workers Day to frighten left-wing activists. In the 1980s their main target was to vandalise shops owned by immigrants. In 1985, a mosque became the target of a homemade bomb.

Norway experienced the worst atrocities since the Second World War when right-wing extremist Anders Behring Breivik detonated a bomb on July 22, 2011 outside the prime minister’s office which claimed eight lives. After the explosion, clothed in a police uniform, he drove to an island outside Oslo where Labour Party’s youth wing had been holding annual summer camp. He shot and killed 69 people, many of whom were between 14 and 19 years old.

Earlier the same day, former prime minister and senior leader of the Labour Party, Gro Harlem Brundtland, also known as the mother of the country, gave a speech to the youths on the island warning them of right-wing extremists. She left before the terrorist arrived.

Breivik, a member of the Christian organisation the Norwegian Order of Freemasons, has been a member of the right-wing orientated party the Progress Party. This party has played an active role in spreading hate against immigrants, particularly Muslims. The main purpose of the July 22 attacks was to target the Labour Party and its youth wing for working for democracy, tolerance and equality.

Right-wing extremist and terrorist Breivik hates Muslims and intended to ruin the Labour Party and discourage people from joining it. He believes that the Labour Party is to blame for the Muslim population in Norway.

 

Toni Usman is a Norway-based professional actor and elected board member of the Norwegian Actors’ Equity Association.

 

toni@toniusman.com

 

Yeh Woh
DIY and spread
happiness

Ramzan is an exceptional time: There’s exception to work, exception to play, exception to rules and regulations et al. The only business as usual in this month of blessings is the wholesale killing of human beings that used to be a specialty of Karachi but is now being practiced in Quetta too.

Life is easy for the white collar employee whose working hours are cut in half during Ramzan. And the afterlife seems rosy too, if they are fasting. As a rule, pretty much every one working out of the comfort of air-conditioned environment has their working hours slashed. Even the British bank closes its doors on customers at midday. The reduced hours are not compensated by opening more counters, and so the result is gross overcrowding on a daily basis.

I exited a stationary and stinking queue and went over to the manager to complain that his staff was enjoying relief at the expense of customers’ convenience. “You know how it is during Ramzan,” he gave me a knowing wink, “people are fasting, they get irritable, and let the steam out when and where they can,” he said, dismissing my contention that trying to serve too many people in too little time may have anything to do with the irritability of customers.

It’s all about perceptions.

A poor brick-layer or gardener can work through the day in blistering summer and frigid winter without expecting or receiving special treatment, breaking his fast with tap water and a few dates, and thank God for it. But an office worker somehow deserves shorter working hours and smaller workload!

If it means nothing or very little will get done in a whole month, so be it. Even those who are at the receiving end of the tradition wouldn’t want to change it. It has become a habit, just like having greasy samosas and pakoras for Iftaar, all month long, year after year. As if it’s a divine commandment: “Ye shall not work, nor make anyone else work during Ramzan, and ye shall always break the fast with pakoras. The more unhealthy your food, the more pious you’ll be adjudged”.

The more noticeable casualty of Ramzan is however, sense of humour.

Pakistani Muslims are not known to have very many funny bones in them anyway, but they become decidedly unfunny when dealing with religion. Someone writes a book in Switzerland, someone tells Pakistanis the author has ridiculed Islam or Islamic practices in that work of fiction, and a mob will gather in Islamabad instantly to stone the American embassy. Humour, in this state of mind, sounds like sacrilege.

Every Ramzan starts the same way: A group of bearded men from all over the country head for the tallest building in Karachi to view the new moon that’ll herald the month of fasting. And this despite the fact that a beard, however long, is not known to enhance vision, and Karachi never has a clear sky. The same group will return to the rooftop in 28 days’ time to decide for us when we celebrate Eid. This practice, unbroken for as long as the tallest building is standing, gave a naughty prayer leader in Peshawar a funny idea.

He gathered his own group of bearded men and started deciding for his followers in the north-west, when to do what. He’s not very creative though, unless following the lead of Saudi government is considered the mother of all creativity. Funny? Yes. But do you see anyone laughing? Instead, they call him a rebel and blame him for dividing Muslims. Not true. Far from it, the rotund and radiating prayer leader, who has no official capacity and whose area of influence is uncertain but small, had the attention of each and every television channel that owns an outdoor camera, when he was announcing the sighting of Ramzan moon a day ahead of the official committee’s sighting.

Seeing the media wallahs tripping over each other to cover the ‘unofficial’ moon sighting announcement, I have another bright idea. All it requires is someone with a beard in every city and village. They are to climb the highest structure around towards the end of Ramzan, with a telescope in hand. They should have had their name and number advertised before hand, so that if they fail, the faithful who have sighted the moon from the window of their basement, can call in as witnesses. Then call in the media and make your announcement. Imagine how many more Eids can we have instead of just two!

 

masudalam@yahoo.com

 

health
Burning issue

Hundreds of people have lost their lives and thousands of others have been injured and physically handicapped in suicide attacks, bomb blasts and drone strikes in Khyber-Pakhtunkhwa.

Sadly, a healthcare system that can effectively react to emergencies is miserably missing in the area: Take burn injuries — majority of the burn victims are referred to Wah Cantonment, where the Pakistan Ordnance Factory has set up a well-equipped burn care centre, or to the Pakistan Army-run burn centre at Kharian. According to officials, only five beds are reserved for the civilian burn patients in Wah from all over Pakistan, and those five beds are always occupied.

Doctors say burn victims having 40 to 50 per cent burns are usually referred to the burn care centres in Kharian and Wah Cantonment in Punjab. Sometime the victims are shifted to Pakistan Institute of Medical Sciences (PIMS) in Islamabad.

Azizullah Khan, an officer at the Higher Education Commission (HEC), says his brother Shafiullah Khan, a tribal journalist, was among the dozens of people seriously injured in the twin blasts at the Khyber Super Market area in Peshawar on June 11. Like other burn victims, his brother was first shifted to Lady Reading Hospital and another tertiary care hospital, Khyber Teaching Hospital (KTH), for the treatment of burn injuries. After two days, Azizullah shifted his brother from KTH to the POF Hospital in Wah Cantonment.

“Our rulers, particularly Health Minister Zahir Ali Shah, had pledged a ‘state-of-the-art’ burn care centre in the province many times in the past, but they never fulfilled their commitment with the people,” Azizullah complained.

In Peshawar, the provincial government established a plastic surgery-cum-burn unit at the Lady Reading Hospital (LRH) in 2009, but it hardly manages to cope with the routine cases of burn victims in the city.

In Pakistan, about 1,388 people have been suffering burn injuries every year since 2001 when violence gripped the region after Pakistan jumped into the US-led war on terror.

Given a sharp increase in violence in the region, neither the number of staff at LRH has been increased nor has the unit been provided with better equipment. The unit has only 12 beds, 6 each for males and females. The unit was started with the appointment of an assistant professor, a senior registrar, a medical officer, two nurses and two dressers.

Dr Mohammad Aslam, in-charge of burn unit at LRH, tells TNS they have got experts and knowledge, but lack space and equipment to cope with the growing number of burn victims. Also, he said they don’t have a female doctor in the whole province to treat female patients.

Besides the LRH, there is another 4-bed burn unit at the Khyber Teaching Hospital (KTH) in Peshawar but, according to doctors and patients, it is ill-equipped and under-staffed.

In the Hayatabad Medical Complex (HMC), there is no proper burn unit, but in case of emergency patients are treated at the plastic surgery unit of the hospital.

In KP, it was Prof Dr Tahir Hassan, who did some serious work in 2009 to establish a burnt unit at the LRH, where he served as general surgeon and his wife Helen Tahir as chief nursing superintendent. LRH is the largest public sector hospital of the province and almost all the victims of suicide bombing, bomb explosions and drone strikes are shifted to this hospital.

After retirement, he moved to London along with his wife and launched a non-governmental organisation called Bridging Frontiers. He continued working there for setting up a burn unit for his people back in Peshawar and collected special expensive beds for burn victims, lights, chairs, special tables and other equipment for the facility. Dr Tahir brought the equipment to the LRH and pledged to provide more such modern apparatus for the unit.

As happens so often in this country, those at the helm of affairs were non-cooperative and discouraged him so much that he abandoned the dream of setting up a burn unit in Peshawar. The equipment that Dr Tahir had brought for the burn unit was installed at the cardiology and cardiovascular units of the hospitals.

The government in 2005 had started work on establishing a well-equipped burn care centre at the premises of the Hayatabad Medical Complex (HMC) in Peshawar and even acquired 20 kanals of land and announced funds for the burn hospital. The Workers Welfare Board had pledged to provide funds from Workers Welfare Fund to the KP government for the construction of 60-bed burn hospital.

The provincial government also pledged to provide Rs250 million for a full-fledged burn hospital and even announced to increase its capacity from 60 to 120 beds.

The Worker Welfare Fund fulfilled its commitment by releasing the amount it had pledged and that helped construct the basement and second floor of the proposed burn hospital. The project, which was supposed to be completed by June 2012, is still in doldrums as the provincial government is yet to release funds for the project.

Prof Dr Muhammad Tahir, a noted plastic surgeon and project director of the burn hospital, tells TNS the provincial government should immediately provide funds for the construction of the remaining two stories of the building. “If the provincial government releases funds for the hospital in time then we would be able to complete the building by June 2012.”

Dr Tahir says it would be difficult for the government to continue construction work on the remaining portion of the building once equipment are installed and the hospital becomes operational.

The ANP and PPP are blaming each other for the poor health facilities in the province. The ANP leadership is of view that it is the responsibility of the PPP ministers holding the portfolios of health and finance to ensure better healthcare to the masses. Health Minister Zahir Ali could not be reached despite repeated attempts by this reporter.

Provincial Health Secretary Prof Dr Noorul Iman tells TNS the provincial government will soon release the remaining funds for the burn care hospital and ensure timely completion of the project. “The government will get latest equipment for the hospital to make it one of the best burn care centres in the region.”

 

Cancerous concerns

Cervical cancer is a growing cancer in Pakistan. It is one of the few cancers that are contracted, in more than one ways. It is, however, more often than not, contracted through unprotected sexual contact with a carrier. The human papillomavirus (HPV), a sexually transmitted infection (STI), in its various strains, is what mostly causes cervical cancer. Thus, a sexually active woman is at risk of contracting the virus. Married or not.

Often the carrier, if a man, will not be affected by the virus himself, but will transmit it to the woman. The vaccine that protects against it, though still being studied upon, is available in Pakistan. Expensive, yes, but potentially life-saving. The best time for a girl to get the vaccine is before the years she becomes sexually active. Hence, teenage years are a good time to get vaccinated against HPV. But in Pakistan, we see a resistance to the idea of getting teenage girls getting this vaccine.

The reason for this resistance, according to Dr Azra Ahsan of the National Committee for Maternal Neonatal and Child Health (NCMNH), is this: “We like to idealistically believe that in Pakistan, sexual relations take place only within marriage. Thus we brush aside the issue of safe sex. And even within a marriage, a woman may be at risk of contracting STIs from her husband. Thus, we encourage that the vaccine be given to girls before them becoming sexually active.”

HPV types 16 and 18 are thought to be the causes of nearly 70 per cent of all cervical cancer cases that occur globally. There HPV may also be a cause of other anogenital cancers, and head and neck cancers.

As it can be sexually transmitted, the incidence of cervical cancer in Pakistan is probably much more than we like to believe. The taboos linked with screening for STIs and the lack of awareness even among educated, urban women that a simple Pap Smear test can be a life saver points in this direction.

When asked which groups of women are most likely to develop cervical cancer, Dr Ahsan says, “Women from poor socio-economic status are the most common victims. Reason could be an absence of early detection. Women with multiple sexual partners also fall in the higher-risk group. Also, women who have had many children tend to be more at risk, as each child birth can cause injury or trauma which can trigger a dormant disease.”

In a country where nine per cent of young women aged 15-19 have begun age bearing, and uneducated young women are more than ten times as likely to have started child bearing by age 19 (according to the 2007 Pakistan Demographic Health Survey — PDHS), the clear indication is that a sizable chunk of the female population, especially in rural or underprivileged areas, becomes sexually active at a young age. Within marriage or outside would hardly be a debate of consequence with reference to the HPV vaccine.

The Total Fertility Rate (TFR) in Pakistan, though has declined, still holds steady at 4.1 children per woman on an average (PDHS).

Fortunately for Pakistan, prevalence for HIV is extremely low with only one-tenth of one per cent of the population affected (Reproductive Health at a Glance, April’11, The World Bank). But use of contraceptives, especially as protection against acquiring STIs which includes HPV, remains low, with only 20 per cent of ever married women (age15-49) using condoms (PDHS). However, even condoms do not provide 100 per cent protection against the highly contagious HPV. Apart from monogamous relations with a single uninfected partner, early detection is the key where cervical cancer is concerned, because by the time the patient starts showing signs, it has already progressed considerably. Once a woman is infected, it can take between five and 20 years for the virus to develop into full cancer, with no symptoms in a lot of cases.

Around six decades ago, a doctor from Cornell University discovered that precancerous cells from the cervix could be identified before they turned lethal. The finding made scientists re-think the screening and treatment of cervical cancer. Dr George Papanicolaou’s “Pap Smear” test became popular. Within the following 20 years, deaths from cervical cancer in the USA decreased by 74 per cent.

The situation, however, is drastically different as far as the developing world is concerned. In today’s world, cervical cancer is primarily a disease found in low-income countries. Annually, nearly 500,000 new cases occur, and out of these, 83 per cent are in the developing world. 85 per cent of the 274,000 deaths associated with cervical cancer are from the developing world. South Asia alone is home to one fourth of the cases of cervical cancer.

According to a World Health Organisation (WHO) study from 2008, Pakistan’s incidence of cervical cancer in 2008 was 19.5 per 100,000, compared to less than 9 per 100,000 in 2002.

The study reported that cervical cancer deaths stood at 12.9 per 100,000 nationally, said Dr Muhammad Tayab, speaking at a press conference organised by the Health Awareness Society (HAS) in October 2010.

A solution came to my attention in a bigger way on a recent visit to Ethiopia, as part of a team called “Women’s Edition” of female journalists from developing countries. Population Reference Bureau (PRB) which organises the Women’s Edition is a Washington DC-based organisation that informs people around the world about population, health, and the environment.

On a visit to St Paul’s Hospital’s Cervical Cancer Prevention Unit working under Pathfinder, a starkly simple solution for early detection of cervical cancer in an economical and effective manner stared at me. The Unit consisted of three tiny rooms with the simple most equipment, and an old steel bed for patients. A senior nurse professional met us, who heads the small team responsible for detection of the earliest signs of cervical cancer of so many women, and in turn saving their lives.

Pap Smears can detect it, but Pap Smears are expensive. And people in Ethiopia or Pakistan are often underprivileged. At St Paul’s, they are using a far less expensive method to screen women for signs of cervical cancer. The method is one of direct visualisation with acetic acid and has gained popularity and proven itself as an adequate alternative to PAP smears in developing countries.

In visual inspection with acetic acid (VIA), 5 per cent acetic acid is applied to the cervix with a large cotton swab and left for 30-60 seconds, after which the cervix is visually examined with the naked eye and a lamp. Pre-cancerous lesions, with a higher ratio of intracellular proteins, turn white when combined with acetic acid. Normal cervices without any precancerous lesions, do not change colour. It is low-cost, requires fewer visits to the physician and the efficacy is about 5 years.

“VIA in Pakistan is done in small pockets, but not enough. In Pakistan, there is no structured screening programme for cancers. VIA is a low-cost method. Medical technicians, if trained, can also do it. Thus, it is a good solution. It should be encouraged that VIA units be set-up in public hospitals,” says Dr Ahsan.

It is time that we seriously think about methods like vaccination against cervical cancer, as well as Pap Smear or VIA, depending on affordability, for early detection. Brushing issues of diseases spread through STIs under the rug will not help solve these growing problems. Acceptance and then looking for solutions — that is the key.

 

Parenting or paranoia?

Most parents today reminisce about their carefree childhoods — frolicking around with friends, visiting neighbours and indulging in harmless mischief… all without their parents constantly keeping tabs on them.

Today the world has changed. Parents hesitate before letting their child walk to the next block. The thought of all kinds of people with dubious intentions interacting with their children is their ultimate nightmare.

And this nightmare has invaded the cyber world as well. This generation was forced to take refuge in front of their game consoles and laptop screens. But most parents now feel that children are no safer in front of these screens than they are out on the open roads.

Cyber stalking, bullying, impersonation, paedophiles hiding behind a computer screen…. These highly publicised stories have redefined parents’ jobs. “The computer should be placed in the middle of the living room,” says one father and most agree.

At times though, this mistrust of the Internet seems to be inversely proportional to the level of computer know-how. I’ve heard parents talk of pop-ups popping up to corrupt their children whereas, for this generation, the Internet symbolises their control. They don’t feel helpless under an attack by random pop-ups, but rather depend upon it for everything — from study groups to entertainment.

Nevertheless, parents do check the Internet history and cookies, use parental control settings to block certain websites or… install spying software. A Google search reveals the abundance of the latter, making it clear that parents are concerned enough to use them. Examples include Spector which takes snapshots of the computer screen at intervals, along with recording all keystrokes, including passwords. EBlaster sends all details of your child’s activity to your inbox. Then there are also other invisible keyloggers: Family Keylogger, Personal Inspector, Home Keylogger — the list goes on and on. Specialised software also exists for cell phones.

“My parents will probably need my help in installing these,” laughs Hamza, a teenage student. That may be true for him but one pressing question arises: Are the creators of these software programmes just catering to parents’ over-protectiveness or are these programmes a genuine necessity in ensuring kids’ safety?

Let’s use an analogy of the world fifty years ago. Can the same people who install this software imagine their parents placing a small device on their bodies to record their whereabouts instantly? The thought is more than a little stifling.

So is this parenting or paranoia? Obviously, parents and children have mostly opposing views.

Like Hamza said, the pressure is definitely on parents to keep up with the upcoming technology. “When my mother first heard of the social networking site, Orkut, she thought that it was a restaurant!”

So by the time parents learn how to check history and cookies, most of their kids (even as young as 7 or 8 year olds) know how to delete them. (Internet Explorer’s In Private Browsing facility has moreover made that unnecessary).

Besides, a Big Brother situation in the house doesn’t do much for character (or trust) building. Compare a teenage boy refraining from visiting certain sites due to his parent’s constant presence over his shoulder with one who understands the ethical or religious values involved, and thus makes an informed decision about his actions. The former is a prisoner and the latter is a law-abiding citizen — the law being his own values.

Sara, another teenage internet user, probably fits the latter category. “My mother indicated that she didn’t like my adding boys on Facebook who aren’t family or close friends. So now I simply don’t, even though my mother doesn’t check. Besides, I’ve added my siblings so it’s all pretty open.”

Sara is lucky because, for many teenagers, their parents become an eternal embarrassment when they are forced to befriend them on these sites. Parents often don’t understand the dangerous waters of peer pressure but, for the child the risk of being labeled a ‘Mama’s boy or girl’ is synonymous with social suicide.

However, parents’ role should definitely not be non-existent for rebellious teenagers. We have to find the middle ground between no parenting and extreme measures, depending on the child’s maturity.

The child, as he/she grows up, should be allowed to make personal decisions. Not giving them this freedom is perhaps only underestimating their sense, and robbing them of the chance of developing their decision-making skills. It might even push them into forbidden land.

Children are like a building — if a strong foundation is laid, one doesn’t have to stand around to ensure that it doesn’t topple. When kids are young, parents should talk to their kids, guide them, and enlist some basic safety rules. That is the right age. I remember a young friend who would play Internet games, and not recognize the profanities she stumbled across. At that moment, it was imperative for the parents to step in and thankfully, they did.

As they grow older, all children should know the risks involved with giving information to strangers on the Internet — a few stories of the horrible incidents that have happened will hit the point home.

Give them some privacy, but know that teenagers will fool around. It’s the parents’ job to ensure that they know the difference between fooling around and compromising their safety.

And yes, addiction is a very real risk too. Shahruz, a student, tells his story: He would wake up late in the mornings, spending the night on the computer. His apparently unsuspecting mother recommended going to a doctor as he was sleeping too much. Later, he found out that she was only trying to scare him into spending less time in front of the screen.

Other parents take the simpler route by verbally banning Facebook during exams, while the more technology savvy ones decide to block the site itself. Not that Facebook isn’t a useful study tool. You do know that the leaked entrance exam papers were all over Facebook, right?

 

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