Final visit to hospitals in Peshawar

Security personnel has been on high alert the last week. During Moharram the whole city was sealed and everything was closed due to fears of fighting between Shias and Sunnis. In Rawalpindi a curfew was imposed due to some conflicts.

I have now collected questionnaires from Naseer Teaching Hospital, Khyber Teaching Hospital, Hayatabad Medical Complex and Lady Reading Hospital in Peshawar.

In Islamabad I got questionnaires from Pakistan Institute of Medical Sciences (PIMS).

I am also expecting questionnaires from Abbottabad.

I have thought about posting pictures of hospitals and patients, but I decided against it because I do not feel comfortable posting pictures of peoples misery and poverty. Maybe I will change my mind later, but right now I do not feel it is right at the moment.

Chappli kebab in Peshawar

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Chappli kebab in Peshawar

The first proper rainy day in Peshawar officially marked the start of the winter season. Suddenly the air is much cooler. My cousins and I took a car ride to a local restaurant to have warm and freshly made chappli kebab (traditional Pashtun kebab).
The picture depicts the traditional large pan where they make and fry the kebabs. You can see that it is a two man job.

Hospital visit and security issues

The road that passes by Naseer Teaching Hospital leads to Mohmand Agency. Mohmand Agegncy is situated in Federally Administred Tribal Areas (F.A.T.A). When I visited the hospital yesterday several of the nurses told me that they were visited by “vaccination people” regularly and asked to fill out forms, but unlike me those people were surrounded by armed guards. They told me it was unusual to see someone coming with questionnaires who were not accompanied by security guards. I was surprised by the comment and did not know what to say. Later I asked my uncle about this and he told me that kidnapping happened regularly and that certain “organizations” had informers everywhere. It sent chills down my spine and I am honestly a little shaken now.

One of my cousins is an officer the Pakistani army. He was one of the officers leading the Swat Operation. He gave us multiple warnings about moving too freely around.

Visit to Naseer Teaching Hospital and Khyber Teaching Hospital (Peshawar)

I  am impressed by the doctors at the government hospitals. With few resources and hardly any equipment each and everyone consult between 50-100 patients every day. Even though I studied in Khyber-Pukhtoonkhwa I had forgotten the large amounts of patients who visit the OPDs and that are admitted in the wards here. There is a mixture of refugees, internally displaced people and local patients.

Strange meeting doctors again with whom I had worked and studied with. Some had asked me questions in viva voce. I am grateful for their co-operation and help in distributing my questionnaire.

Adolescent and Sexuality: Who should fill the communication gap?

I would rather start by challenging the definition of adolescent by WHO which consider an adolescent as a person between 10-19 years of age. With rapid change in human life style, there has been an increase in number of children with maturation starting at an age of 7 “precocious puberty”. For those who do not understand what precocious puberty is, it simply means puberty which start at an age between 7 and 9 years. With this era, I would define an adolescent as a child between 7 to 19 years so as I don’t lose those between 7 and 10 years especially when it come to planning.

I will give you an example. One day I was asked to visit and teach on issues of adolescent sexual and reproductive health in one primary school with religious background. I was informed the age group attending the meeting will be between 12 and 16 of whom I may call them adolescent by WHO definition. Surprisingly, when I arrived there, I saw younger children than I expected. After a short survey I made I realized they were between 7 and 11 years old. I was curious to know where the older children were and I was told that, “they have exams and they won’t be allowed to come from the examination room to attend the meeting and I should continue with those younger children”.

The religious leaders were part of the meeting so I could not use my notes lest they say I went there to teach their children something which they were not supposed to be taught. I started by asking a question, what is puberty? In Swahili language “Nini maana ya Balehe?” Almost all students raised their hands with great desire to answer my question. While choosing someone to answer, I was looking where religious leader were seating and all of them were puzzled and down faced. To mention few answers, “something dirty coming from down, doing sex like the way father and mother do, feeling good when a girl come close to me, breast development, being a man etc. were the answers given to my question.

On the other hand, Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles and relationships. While sexuality can include all of these dimensions, not all of them are always experienced or expressed. Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical, religious and spiritual factors (WHO).

Let me share another example, a girl NM who passed away at an age of 13 years after being advised by fellow student (A boy) who gave her pregnancy. They used chloroquine tablet as the way of aborting the pregnancy. She used 13 tablets which caused her to die. When parents were interviewed, both said, “our girl was so humble, she never started sex”. Then he was asked again, how did she get pregnancy? Both parents never had an answer rather than crying.

The issue here is, the girl entered into puberty and none ever tried to help the girl to enter into this stage safely. In the current generation which I would call a dot com generation where parents and care takers are busy and having limited time with their children, leaving adolescent falling in love with peers seeking for advises. I challenge everyone who will read this article, if you don’t talk to them, Google, you tube, pornographic websites, peers, sugar daddies, sugar mummies will talk to them. My question is, who really take time and address issues of sexuality to adolescent children especially in areas where blind culture norms exists? Most of them end up in dilemmas reaching to a point of messing up. They need my help. They need your help. They need help from parents or guardians. They need the help from the whole community. It’s high time to act and you should act now and fill the gap.