Where RH & FP Matters

A community where RH & FP Matters
Social Mobilizer of HANDS conducts a mini seminar on the topic of “Family Planning : a happier way of prosperity” attended by more then 50 women , at District Umerkot.

Where There is No Health Facility

A woman, local health Care provider who demonstrates to community at health awareness session the women neither can read nor write but she technically has been trained to provide first aid services to community where there is no health center.

What I believe ………..

· Transgender are humans; should be treated at par accordingly.

· The affected family should understand and have the knowledge and information regarding psychological problems of the child behaving in a socially deviant way. If child is showing gender identity problem he/ she should be taken to the psychiatrist/ psychologist for necessary treatment.

· Parents should take due cognizance of their child getting undue affection from others without any apparent reason. They should check the company their child keeps.

· Government/ local administration should arrange stipends and monetary assistance to the poor and provide employment to the effected sections of people.

· Those who are born with the sexual deformity should be provided either handsome financial help so that they could become acceptable in their own families and they should be given share/ quota in employment for the handicaps, enabling them to lead normal life.

· Government should devise ways to disseminate information regarding psychological problems related to sexual minorities and develop public awareness programs to handle the issue.

· Government should also develop programs to enhance and build up knowledge regarding AIDS/ STDs to the masses and transgender as well.

· Government should arrange the medical assistance for affected individuals and enforce strict law on auto-castration.

A New Frontier in Civil Liberties-Equal Rights for Transgender

Transgender rights represent a relatively new frontier in civil liberties activism. In Pakistan, eunuchs have historically been disregarded and marginalized by mainstream issue advocates. The discriminations against eunuchs reveal our petty-bourgeois mentality that is mostly reluctant to recognize gender deviance.
Over the years, the complete isolation of eunuchs from the very fabric of our society has denied them access to education, employment and health care – a direct violation of fundamental rights. Instead, they are forced to beg, dance, and enter prostitution as the only means of livelihood. Forms of discrimination impacting them include housing discrimination, discrimination in public accommodations, and violence, rape and forced prostitution. Discriminatory behavior has also forced eunuchs to resort to living in isolated colonies, shunned by society.
To demystify the shrouded lives of eunuchs here, we must begin with an understanding of our society. Ours is a society with a blatant male privilege – the patriarchal orientation reigns supreme as an institution that organizes much of life, exhibiting a natural preference for sons over daughters. While we battle against gender discrimination, transgendered children have little or no space in the social set-up.
In fact, when it comes to analyzing the life of a eunuch, we find ourselves immensely confused owing to gender-role socialization which is rampant in our society. It’s safe to assume that our understanding of genders is not only discriminatory, but we are also clearly confused about the spectrum of gender. It is this unfortunate condition that has led to the marginalization of the eunuch community and forced them in to the world of sexual exploitation.
Despite years of discrimination, the eunuch community has survived the taunts, humiliation, and savagery, and continues to fight back. Islamist jurist Dr Mohammad Aslam Khaki joined their struggle as he filed the petition for the welfare of the unfortunate and vulnerable community abandoned by society. Dr Khaki’s activism led to the Supreme Court ruling in favor of the protection of eunuch rights.
Dr. Khaki researched the conditions in which eunuchs live and discovered them to be the most oppressed and deprived segment of society, subjected to humiliation and molestation.
Responding to a query, he told the court that there are about 80,000 eunuchs in Pakistan. Parents give their gender-confused children into the care of gurus (leaders of eunuchs) at a very tender age. They get no opportunity to study and are instead trained to beg, dance or become prostitutes.
The court order thus requires the social welfare authorities to register and research the particulars of the eunuchs, and the circumstances in which parents hand over their children to gurus. The court has further ordered an evaluation of the offence such parents commit as they willingly give their children away to eunuch leaders at the time of birth.
At this point, it is difficult to ascertain the future of the eunuch community in Pakistan. While we laud the stupendous effort of the Supreme Court to ensure every Pakistani citizen’s human rights, we must acknowledge that the issue is far more complex and will take a lot more than surveys and court rulings. No doubt, the survey is a step forward in recognizing the existence of the mostly ignored factions of our society. It is also bound to face critical issues, such as how to differentiate between eunuchs, cross-dressers and sexually ambiguous or androgynous people who don’t identify with any gender or sexual orientation.
The fact is, surveys cannot be the only route to justice because they cannot account for the psychological aspect of sexuality and transgender issues. Whether the Pakistani judicial system – and, more importantly, the public at large – is ready to come to terms with the findings of the survey and the complexity of transgender issues remains to be seen.
With courtesy: http://blog.dawn.com/2010/01/05/a-new-frontier-in-civil-liberties/

Human Rights and Transgender People in Pakistan

There is no known grassroots activism among lesbians, gays, bisexuals, transsexuals and transgender (zenana) communities in Pakistan. This lack of activism, the silences around sexuality(ies), and deeply closeted status of most gays and lesbians in Pakistan (many of whom live double lives to avoid revealing their sexual orientation) makes it difficult to accurately assess their living conditions and human rights situation. Anecdotal information from Pakistani gay people who have left the country describes fear, secrecy, isolation, suicides, forced marriage, family and community pressure to conform to heterosexual norms.

Against this background, a landmark case involving transgender rights is currently unfolding in Pakistan. Nighat Saeed Khan, director of ASR Resource Centre in Lahore, Pakistan notes that, “Transgender individuals in Pakistan have typically faced a myriad of dangers from police, family, community, and religious authorities, and had to leave the country.” The current case challenges this status quo. It marks an attempt by a female-to-male transgender man and his wife to have their marriage recognized, an outcome that is predicated on the court’s recognition of the right to transgender identity.

Transgender- Fight for Right

Though homosexuality is criminalized in Pakistan with penalties ranging from fines to imprisonment to death by stoning, the Pakistani Supreme Court ruled this week that trans citizens should have greater access to benefits and equal rights. It's a welcome development, for a country that along with Egypt, Libya, Sudan, and Iran have fought to portray LGBT rights as a western concept imposed on countries around the world by an immoral and extravagent western world.
Still, good ruling aside, this doesn't necessarily mean the end of persecution for trans folks in Pakistan. But first,

Here's a summary of the Supreme Court in Islamabad's ruling:

The Supreme Court has ordered that trans people, being equal citizens of Pakistan, should also benefit from the federal and provincial governments’ financial support schemes...
‘They are citizens of Pakistan and enjoy the same protection guaranteed under Article four (rights of individuals to be dealt with in accordance of law) and Article nine (security of person) of the Constitution,’ ruled a three-member bench comprising Chief Justice Iftikhar Muhammad Chaudhry, Justice Muhammad Sair Ali and Justice Jawwad S Khawaja.
Tangibly, there are a few things that this ruling should do. It should:
Allow trans people to receive financial support through Bait-ul-Maal (a worldwide relief and development organisation);
Require that the government survey, likely through a census, the number of trans people living in Pakistan, which is estimated to be around 400,000; and
Direct Pakistan's Interior Ministry to ensure that police officers are providing protection to trans people from criminal elements
Those sound like good things, and if they are enforced, this ruling will do wonders. As Gay Persons of Color blog notes, "After years of discrimination and exploitation during which transgender persons in Pakistan have often been refused entry to schools and hospitals, turned down properties for rent or purchase, and have even been denied formal burial rites after death, this recognition of the community as a protected minority is an historic step."
A historic step, for sure. But in a throwback to reality, one of the plaintiffs in this case demonstrated just how dire the situation is for LGBT people in Pakistan.

The plaintiff, a trans person known as Shazia, said outside the court:

My appearance before the court today may cost me my life. Once I was implicated in a false case and subjected to immense sexual torture by the police...
Frightening that simply appearing in court to fight for your rights could end up getting you killed.
Still, this decision is a move in the right direction for a country that remains one of just a few to still keep capital punishment on the books as punishment for sexual orientation. Here's hoping that the ruling also affirms that courts in countries like Pakistan can be an objective force for determining the rule of law and protecting civil rights, as opposed to branches of a religious sect hell-bent on enforcing religious dogma.

With courtacy : Dawn Newspaper :www.dawn.com

HIV/AIDS -Pakistan at a Glance

Pakistan still has a window of opportunity to act decisively to prevent the spread of HIV. Although the estimated HIV burden is still low—around 0.1 percent of the adult population—the country is facing a concentrated epidemic among injecting drug users (IDUs) with HIV prevalence above 5 percent among IDUs in three of the four provinces.
Given linkages between IDUs and other high-risk populations including male and female sex workers, Pakistan needs to scale up targeted intervention urgently to prevent rapid increase in HIV among vulnerable groups.

STATE OF THE EPIDEMIC

According to UNAIDS estimates, about 96,000 people were living with HIV in Pakistan at the end of 2007. Officially reported cases are, however, much lower. As in many countries, underreporting is due mainly to the social stigma attached to HIV, limited surveillance and voluntary counseling and testing systems, and the lack of knowledge among the general population and health practitioners. Although overall HIV prevalence is low in Pakistan, there is growing evidence of local concentrated epidemics among IDUs in major cities across the country. The combination of high levels of risk behavior and limited knowledge about HIV among injecting drug users and sex workers could lead to the rapid spread of HIV.

RISK FACTORS
There are serious risk factors that put Pakistan in danger of facing a rapid spread of HIV if immediate and vigorous action is not taken:

Concentrated Epidemic among Injecting Drug Users: The number of drug dependent people in Pakistan is estimated to be about 500,000, of whom an estimated 100,000 inject drugs. In 2006, HIV prevalence rates among IDUs ranged between 10 to 50 percent across Quetta, Faisalabad, Hyderabad, Karachi, and Sargodha. The majority of these IDUs were either married or sexually active. The common risk factor for the majority of infected drug users was that they used non-sterile injecting equipment, and awareness of HIV transmission routes was relatively low. Safe injection practices are more prevalent in cities such as Lahore and Peshawar where targeted interventions have been in place over a longer period.

HIV among Male Sex Workers and Transgender: Surveillance data for 2006 point to a local concentrated epidemic among MSWs and Hijras in Larkana and Karachi in the Sindh province while prevalence elsewhere is still below 5 percent. Behavioral surveillance data for 2006 indicates very low levels of condom use among MSWs and transgenders across all cities surveyed. One in four of the male sex workers said they also bought or sold sex to women. Such high-risk behavior must be addressed in order to limit the further spread of HIV in and beyond those sexual networks.
Unsafe Practices among Female Sex Workers: Commercial sex is prevalent in major cities and on truck routes. Behavioral and mapping studies in three large cities found a sex worker population of 100,000 with limited understanding of safe sexual practices. Condom use is still low during commercial sex encounters although consistent condom use is more prevalent in Karachi and Lahore where targeted interventions were initiated in 2004. Furthermore, sex workers often lack the power to negotiate safe sex or seek treatment for STIs. High levels of sexually transmitted infections indicate widespread sexual risk taking.
Inadequate Blood Transfusion Screening and High Level of Professional Donors: It is estimated that 40 percent of the 1.5 million annual blood transfusions in Pakistan are not screened for HIV. About 20 percent of the blood transfused comes from professional donors.
Large Numbers of Migrants and Refugees: Large numbers of workers leave their villages to seek work in larger cities, in the armed forces, or on industrial sites. A significant number (around 4 million) are employed overseas. Away from their homes for extended periods of time, they may be at increased risk for exposure to HIV.

Unsafe Medical Injection Practices: Pakistan has a high rate of medical injections: around 4.5 per capita per year. Studies indicate that 94 percent of injections are administered with used injection equipment. Use of unsterilized needles at medical facilities is also widespread. According to WHO estimates, unsafe injections account for 62 percent of Hepatitis B, 84 percent of Hepatitis C, and 3 percent of new HIV cases.
Low Levels of Literacy and Education: Efforts to increase awareness about HIV among the general population are hampered by low literacy levels and cultural influences. In 2006, female literacy was estimated at 42 percent.

Vulnerability Due to Social and Economic Disadvantages: Restrictions on women's and girls’ mobility limits access to information and preventive and support services. Young people are vulnerable to influence by peers, unemployment frustrations, and the availability of drugs. In addition, some groups of young men are especially vulnerable due to the sexual services they provide, notably in the transport sector. Both men and women from impoverished households may be forced into the sex industry for income.

NATIONAL RESPONSE TO HIV/AIDS
Government: Pakistan’s Federal Ministry of Health initiated a National AIDS Prevention and Control Program (NACP) in 1987. In its early stages, the program was focused on diagnosis of cases that came to hospitals, but progressively began to shift toward a community focus. Its objectives are the prevention of HIV transmission, safe blood transfusions, reduction of STI transmission, establishment of surveillance, training of health staff, research and behavioral studies, and development of program management. The NACP has been included as part of the government's general health program, with support from various external donors.

As the government has indicated, more needs to be done. For example, focus on reducing the exposure of high- risk groups is urgently required as is increasing the service coverage of key populations (injecting drug users, female sex workers, men who have sex with men and prison inmates). Other priority areas that require attention include improving access to quality treatment and care, strengthening the monitoring and evaluation system, continued advocacy with policy makers and other influential groups, and effective coordination with key agencies including police, jail authorities, and the Ministry of Law and of Narcotics Control. In early 2001, the Government of Pakistan, through a broad consultative process, developed a national HIV/AIDS Strategic Framework that set out the strategies and priorities for effective control of the epidemic. The government has finalized costed action plans for the next phase of the federal and provincial Programs covering the period from 2009-2013.

A draft national AIDS policy and HIV and AIDS Law (both recommending the formation of a National AIDS Council) have been prepared by the National AIDS Control Programme and will be presented to the national cabinet and parliament. Approval of the policy and law would be an important step towards the multi-sectoral dimension of the national response.

Nongovernmental Organizations (NGOs): At least 54 NGOs are involved in HIV/AIDS public awareness and in the care and support of persons living with HIV/AIDS. These NGOs also work on education and prevention interventions targeting sex workers, truck drivers, and other high-risk groups. NGOs serve as members of the Provincial HIV/AIDS Consortium, which has been set up in all four of Pakistan’s provinces to coordinate HIV/AIDS prevention and control activities. Although NGOs are active in HIV/AIDS prevention activities, it is believed that they are reaching less than 15 percent of the vulnerable population.


Donors: There is a Theme Group and a Technical Working Group on HIV/AIDS to coordinate the response of United Nations Agencies and to provide assistance to the government in the strategic development of activities. The theme group includes UNAIDS, WHO, UNICEF, UNFPA, UNDP, UNDCP, UNESCO, ILO, the World Bank, national and provincial program managers, and representatives of nongovernmental organizations.
ISSUES AND CHALLENGES: PRIORITY AREAS
Vulnerable and High-risk Groups
• Expand knowledge, access, and coverage of vulnerable populations—particularly in large cities—to a package of high impact services, through combined efforts of the government and NGOs.
• Implement harm-reduction initiatives for IDUs and safe sex practices for sex workers.
• Make effective and affordable STD services available for high-risk groups and the general population.

General Awareness and Behavioral Change
• Undertake behavioral change communications with the following behavioral objectives:

(i) use of condoms with non-regular sexual partners;
(ii) use of STI treatment services when symptoms are present and knowledge of the link between STIs and HIV;
(iii) use of sterile syringes for all injections;
(iv) reduction in the number of injections received; (v) voluntary blood donation particularly among the age group 18 to 30);
(vi) use of blood for transfusion only if it has been screened for HIV; and
(vii) display of tolerant and caring behaviors towards people living with HIV and members of vulnerable populations.

• Increase interventions among youth, police, soldiers, and migrant laborers.

Blood and Blood Product Safety
• Ensure mandatory screening of blood and blood products in the public and private sectors for all major blood-borne infections.
• Conduct education campaigns to promote voluntary blood donation.
• Develop Quality Assurance Systems for public and private blood banks to ensure that all blood is properly screened for HIV and Hepatitis B.

Surveillance and Research
• Strengthen and expand the surveillance and monitoring system.
• Implement a second-generation HIV surveillance that tracks sero-prevalence and changes in HIV-related behaviors, including
the spread of STIs and HIV, sexual attitudes and behaviors, and healthcare-seeking behaviors related to STIs.

Building Management Capacity
• Continue to build management capacity within provincial programs and local NGOs to ensure evidence-based program implementation.
• Identify gaps in existing programs and continue phased expansion of interventions.