WUNRN
|
For women like Nuzhat, revealing one's HIV status simply
isn't possible. There are some 85,000 people living with HIV in Pakistan
today - including an increasing number of women |
KARACHI, 6 December 2007
(IRIN) - Bound by 'watta satta', a cultural tradition of exchanged marriage
between two families, Nuzhat (not her real name), 22, cannot disclose her HIV
status.
"I know well what will happen - I'll be thrown out
of my husband's home and my own family will never accept me either. It will
also mean my brother's home will be ruined. His wife is my husband's sister and
she, too, will be sent packing. In any case, where will I go?" she asked
in Karachi, provincial capital of Sindh Province in southeastern Pakistan.
The tradition of watta satta, which literally means
'give and take', or 'throwing a stone and receiving something back', describes
the exchange of brides between families, in which a brother and sister from one
family are married to a pair from another family, often close relatives.
About a third of all marriages in rural Pakistan take
place on a watta satta basis, according to research. In some parts of the
country, like Sindh Province, the rate is even higher.
Nuzhat is a classic case of the feminisation of HIV and
AIDS that seems to have taken a toll on younger women in the Asia-Pacific
region, where the epidemic is being fuelled primarily by the gender inequality
that prevails.
Health experts estimate there are 85,000 HIV-positive
people in a population of over 160 million in Pakistan - but around 50 percent
of them are in Sindh.
According to UNAIDS, almost 40 percent of new HIV cases
occur among women, and the Global Coalition on Women and AIDS, a UNAIDS
initiative, says women currently represent 30 percent of adults living with the
virus in Asia. Accurate figures on the number of infected women in Pakistan are
not available.
Entrenched age-old social attitudes, practices and
stereotyping, which often lead to violence against women, coupled with unequal
access to economic resources, are hampering progress towards dealing with the
spread of HIV/AIDS.
Marriage no protection
At the eighth International Congress on AIDS in Asia and
the Pacific, held in August 2007 in Sri Lanka, the worrying trend of a rising
rate of HIV among young married women was reported.
Dr Naseem Salahuddin, an infectious disease specialist
at Karachi's Liaquat National Hospital, notes the increasing transmission of
the virus from husbands to their wives: a third of the 200 people living with
HIV/AIDS that she has treated since 1998 are women, mostly wives. "It's
not just a health issue, and must be looked on as a socio-cultural one,"
she commented.
Keeping her illness secret out of fear while receiving
no treatment is putting unbearable pressure on women like Nuzhat. "I can't
keep up a brave face any longer," she lamented.
Dr Saleem Azam has been working with injecting drug
users (IDUs) for the last 25 years and has 5,000 IDUs registered with his
organisation, the Pakistan Society. In the last few years he has seen a
disturbing spread of the virus among IDUs and fears the impact it will have on
others, particularly women.
|
Open
discussion about HIV in Pakistan remains taboo |
Azam convinced Nuzhat's
husband to have her tested, but when he first saw her six months ago "she
was at a breaking point" and he had to send her for psychiatric
counselling. "It's not the stigma she thinks she will face; it's the
outright rejection from her family that she knows is there," Azam said.
Nuzhat's husband, Taufiq, a daily wage earner, is not
only an injecting drug user - including heroin - but also consumes alcohol and
has multiple sexual partners; knowing his HIV-positive status or that he has
infected his wife and possibly his daughter has made little difference to his
life.
When "there was nothing to eat" at home,
Nuzhat decided to get a job. Without proper qualifications she had few options
but to work in a local beauty parlour, though she cannot step out without a
male escort.
Taufiq maintains his lifestyle on his meagre and
sometimes uncertain income because he often beats up Nuzhat and forces to part
with her wages, or otherwise he borrows from his mother.
Her health is deteriorating, but her husband takes
little notice. "I often get fevers. Boils erupt out of nowhere but I am
too scared to seek medical help. I'm always accompanied by some family member.
If I go to see a doctor, my mother-in-law will come. What if she suspects something
and discloses it?"
Our sole reason for existence seems to be to procreate
or provide sexual pleasure for men.
Our sole reason for existence seems to be to procreate or
provide sexual pleasures for men.
|
This fear not only stops her from seeking help from
one of the centres run by the Sindh AIDS Control Programme (SACP), part of the
National AIDS Control Programme, but keeps her from having her two-year-old
daughter tested, who is also often sick. "I can't take the risk," she
told IRIN/PlusNews.
She felt that women in her family are never given the
status of humans: "We are treated like cattle, beaten up regularly on the
slightest of pretexts," Nuzhat commented.
"Our sole reason for existence seems to be to
procreate or provide sexual pleasures for men. Even my mother thinks that way,
as does my mother-in-law. They both live in the city, but it does not mean
their mindset has changed. Sometimes I feel ... I'll become like them if I
continue living in this suffocating environment."
Discrimination, unequal power relations between men and
women, and economic dependence have exacerbated the issue, Dr Azam said.
"The unequal power makes women more vulnerable, leading to coercive and
violent sex, which often puts them at a disadvantage, with little option to
either refuse sex or negotiate for safe and protected sex."
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