The Express Tribune hi five - April 26

Ms APRIL 26, 2015

ISSUE NO. 149

Cesarean on demand?

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Ready, steady, cook!

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inside En vogue — Colourful couture

Domestic goddess —

Southwest chicken sandwiches

Section In-Charge: Dilaira Dubash Sub-Editors: Amna Hashmi Nisma Chauhan Designer: Umar Waqas Feedback: women@tribune.com.pk

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The vibrant Sanam Choudhri

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The buzz

THE EXPRESS TRIBUNE, APRIL 26, 2015

Cesarean deliveries may be at an all-time high around the world but are they really worth it?

By Ishrat Ansari

These days, it seems like everyone has had or knows someone who has undergone a C-section during childbirth. According to Women’s Health Magazine, the US witnessed a 60% spike in cesarean delivery rates between 1996 and 2009, alone. More and more women seem to be opting for the surgical procedure without any obvious need for it. But as it turns out, streamlining one’s delivery process prior to time isn’t always a safe bet.

In a nutshell, a C-section involves making an incision in the patient’s abdominal wall so as to retrieve the baby from the uterus. It may sound simple but in reality, the procedure entails many risks and complications which put both the patient and baby at risk. For starters,

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Design by Maryam Rashid

the laceration made into the expecting mother exposes her to airborne bacteria, which can ultimately lead to infections. There is also a greater chance of excessive bleeding, blood clots and accidental injuries to surrounding organs, such as the bowels or bladder. The recovery period also varies between normal and cesarean births with a maximum of two weeks required for the former. Patients undergoing C-sections, on the other hand, sometimes take up to six weeks to heal satisfactorily.

Although it is rare, some extreme cases of cesarean deliveries can also prove fatal. “The mortality rates have definitely decreased over the years, due to C-sections,” says Dr Nusrat Shah Kamal, a consultant gynecologist at Civil Hospital in Karachi. Her colleague, Dr Nighat Shah,

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THE EXPRESS TRIBUNE, APRIL 26, 2015

a gynecologist at Aga Khan University Hospital (AKUH) in Karachi agrees and says, “Earlier, there were not enough safety measures but nowadays, if the mother and child are in jeopardy, a C-section is a viable, lifesaving option.”

Many experts believe that basic evolution of the human body has spurred the popularity of cesarean deliveries.

“The size of the human brain (head) has increased over the centuries but the female pelvis remains the same,” explains Dr Shah. “If a woman is in the last stages of labour but can’t push, we opt for a C-section.” She also cites domestic purposes, such as immigration processing as encouraging women towards the surgery.

“Sometimes, they want their babies delivered within 38 or 39 weeks or by specific dates,” adds Dr Shah.

Nonetheless, both Dr Kamal and Dr Shah suggest that the procedure should only be administered once all other options have been exhausted. For instance, in the case of 29-year-old mother of two Mahnoor Saif*, a C-section was a must. “During my first pregnancy, I didn’t experience any labour pains and other unforeseen complications arose,” shares Mahnoor. “The second time around, my baby wasn’t moving down and it was found that the umbilical cord was wrapped around the neck. Once again, I had to go into surgery.”

Dr Shah adds that the majority of deliveries in Pakistan are performed normally and believes, “If a doctor does a C-section without waiting for proper medical indications, it is completely wrong.”

There are a handful of medical conditions doctors will search for to warrant the surgery. A history of infertility, birth defects in the fetus, multiple pregnancies, hypertension, diabetes, previous surgeries, nonprogressive labour and a baby in breech (feet/bottoms first) or the transverse (sideways) position, are some of the indications required before an incision is made.

Dr Kausar Salam, a senior gynecologist running two birth clinics in Karachi for the past 20 years, shares the example of her patient, 27-year-old Nuzhat Suhail* to highlight the importance of informed judgment and medical indications. “Nuzhat conceived after seven years so taking her into a trial period during labour could have been life-threatening,” recalls Dr Salam. “Not to mention, the child was heavy and Nuzhat herself was very weak.”

Fortunately, Nuzhat is now the proud mother of a beautiful baby boy.

Interestingly, cesarean deliveries appear to be more common in public hospitals than private ones, owing to

the poor health of the patients that visit them. “Most of the women are anemic, poor or in their seventh or eighth pregnancy,” explains Dr Kamal. “Many a times, they simply aren’t strong enough for a normal delivery and therefore, about 40% to 45% of babies in public hospitals are born surgically.” Despite this, about 80% of births in Pakistan are still performed normally, according to Dr Kamal.

The charges for cesarean deliveries are much higher relative to normal births, with a 50% to 65% increase in fees across Karachi. “Many private hospitals are thriving on money made from unnecessary C-sections, adds Dr Kamal. “The procedure is very profitable as a normal delivery can take up to eight hours or more. The good thing about C-sections is that a doctor can deliver three babies in three hours and so, save time while earning thrice the amount!” She says hospitals ought to charge equally for both types of procedures so as to discourage patients from unwarranted cesarean deliveries.

Dr Salam, however, believes that patients and reputation are much more important than commercial gains. “The notion that C-sections are an option for expecting mothers to consider is completely unethical and incorrect,” says gynecologist Dr Salam. Granted, many expecting mothers ask for cesarean deliveries out of fear of labour pains and the number of those in genuine need of it might be rising but most doctors remain apprehensive of the procedure. “I don’t believe C-sections have become a trend now,” says Dr Shah.

“Also, in my experience, rarely do patients actively ask for one.” And in the case where they do, their wishes are answered only due to mitigating circumstances like that of 30-year-old Ruma Tariq*, who lost her first born during a normal delivery. “My first child died shortly after birth, due to some respiratory problems,” shares Ruma.

“After that, I was so fearful of losing my second child, I asked for a C-section.” Ruma is now the mother of three children, all of whom were born via surgery.

Regardless of how the baby is delivered, all doctors call for familial support and care during this trying time in a woman’s life. “The most important thing is that the patient should not be left alone at the crucial hour as this will aggravate their fear,” says Dr Kamal. A perfectly healthy, normal delivery should be the aim, through sound time management and support. *Names have been changed to protect privacy.

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En vogue

Samia Ahmed showcases her latest collection

Coordination and art direction: Umair bin Nisar Make-up: Rhyan Thomas Designer: Samia Ahmed Photography: Umair bin Nisar Model: Rubab Ali

THE EXPRESS TRIBUNE, APRIL 26, 2015

THE EXPRESS TRIBUNE, APRIL 26, 2015

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Lifestyle

THE EXPRESS TRIBUNE, APRIL 26, 2015

Over the past few years, Pakistanis have taken the world by storm in a variety of fields. Sharmeen Obaid Chinoy brought home our very first Oscar, Aisam-ul-Haq Qureshi is ranked amongst top international tennis players and Fawad Khan is the current it-boy in Bollywood. With so much talent under our belt, it only makes sense to try our hands at food and dining and that is precisely what Pakistani-born Australian Faiza Rehman aimed to do when she entered MasterChef Australia as a contestant.

Although the 25-year-old was unfortunately eliminated during the course of the season, Faiza managed to win hearts and put Pakistan on the culinary map of the world. And what’s more, she hasn’t let her elimination dissuade her!

Most recently, Faiza was amongst the judges at a series

Pakistan is preparing its youth for the burgeoning global culinary industry

By Rahat Kamal | Design by Hira Fareed

contestant and COTHM student Noor-us-Sabah Shariq.

“I was overjoyed when I first heard of the competition and rushed to register.” Noor, who aspires to become an executive chef, said, “Such events pave the way for ambitious women to enter the global food industry.”

Faiza was also accompanied by celebrity chef Munawar Latif as part of the panel of judges. Munawar is not only a faculty member at COTHM but has over 25 years of culinary experience. “Events such as these are highly advantageous and should be arranged frequently,” he said. “They foster healthy competition and inspire us to be our best,” he added, explaining that even though the profession is highly respected globally, it still hasn’t garnered much reverence in Pakistan. Faiza agreed and claimed that the tangy and aromatic flavours of Pakistani cuisines are yet to receive the global recognition enjoyed by Chinese or Indian foods. “I envisage reinventing Pakistani cuisine, so that it is included in the household menus of every person around the world,” said Faiza. She suggested that, Pakistani food needs to be given a modern touch, whilst staying true to its traditional

I envisage reinventing Pakistani cuisine, so that it is included in the household menus of every person around the world MasterChef Australia contestant Faiza Rehman

of cooking competitions held at Karachi’s College of Tourism and Hotel Management (COTHM) on April 15.

Held in Karachi, Lahore and Islamabad, as part of the annual Australia Day celebrations, the competition was a collaboration by COTHM, Chef’s Association of Pakistan, Empower a Woman Empower a Nation (EWEN) and the Australian High Commission. The aim of the competition was to not only strengthen ties between Pakistan and Australia but also to promote local culinary artists and dishes. “The event is a beautiful showcase of Australian skills and Pakistani talent,” said Ayesha Bux, Honourary investment consular in Melbourne and the brains behind the EWEN initiative. “I am immensely surprised by the amount of talent Pakistani youngsters have shown,” said Faiza. “I loved the students and their eagerness to learn. They were delighted to receive my comments and took criticism constructively as well,” she added.

The theme for this year’s competition was gender equality and female empowerment which encouraged many female chefs to participate as well. Although food and drink are amongst the favourite activities of Pakistanis, it is surprising that very few women have been able to make a mark for themselves locally. The competition brought forth a world of hidden talent, such as that of

Faiza Rehman along with Peter and Susan Heyward, judging the dishes made by the contestants.

flavours, in order to make it relevant for fine dining.

Nonetheless, with the exceptional dishes put forth by the contestants, one can gauge how successful the local culinary industry can become if given the right infrastructure. Australian High Commissioner Peter Hayward and his wife Susan were amongst the judges blown away by the standard and quality of the food made, although most of the contestants are yet to graduate from COTHM. “The standard of the competition was very high and the food was marvellously cooked and presented,” said Peter, who was delighted to see so many Pakistani women take part.

While the contestants included both male and female students, the trophy was won by an all-women’s team for preparing a three-course recipe given by Faiza. The competition proves that with a little help and push in the right direction, Pakistani women can achieve just about anything they set their eyes on.

The panel of judges.

PHOTO SOURCES: COTHM AND FB.COM/FAIZA-REHMAN

Domestic goddess 7

THE EXPRESS TRIBUNE, APRIL 26, 2015

By Huba Akbar

Southwest Chicken Sandwich

A sandwich with a tangy twist

Ingredients

Method For the sandwich: • Cook the chicken breasts in black pepper, salt, garlic, vinegar and olive oil until it is cooked completely.

• Once the meat is done, snip it into small pieces and mix it with garlic mayonnaise, salt and mashed boiled eggs to make a paste.

• Spread the chicken paste, capsicum, coriander and carrots onto two slices of bread and press them together. You can cut the sandwich into triangles or any other shape you want.

For the sauce: • Combine all the ingredients together and mix thoroughly.

• Allow the sauce to chill in the refrigerator for at least one hour before serving it with the sandwiches.

For the sandwich: • Garlic mayonnaise 3/4 cup • Bread 4 or 5 slices • Eggs (boiled) 1 or 2 • Capsicum (chopped) 1/4 cup • Coriander (chopped) 1/2 cup • Carrots (chopped) 1/4 cup

Top tips for sandwich lovers Use the right bread: No matter what type of sandwich you are making, selecting the appropriate bread is crucial. For example, pairing a moist sandwich filling with soft, fluffy white bread will give you a sponge, not a sandwich. Such filling is best suited for dry bread which is dense in texture to help lock the moisture in. A strong, thick crust helps too as it holds the inner ingredients together and adds taste to the overall sandwich.

• Vinegar 4 tsp • Chicken breast halves (skinned and boneless) 2 • Black pepper powder 1/2 tsp • Salt 1/2 tsp • Olive oil 3 tbsp • Garlic cloves (minced) 6 For the Southwest sauce: • Mayonnaise 1/2 cup

Control the sogginess: Most people don’t know it but spreading cheese paste, butter or mayonnaise all the way to the edges of the bread helps create a seal against wet sandwich fillings. Also, it is advisable to keep high-moisture ingredients like pickles, cucumbers or tomatoes separate from the sandwich until the time of eating as these release juice and water which dampen the bread. Alternatively, you can toast the slice before applying the pastes as well.

Recycle leftovers: Did you know that leftovers from last night’s dinner make for excellent sandwich fillings? Any kind of meat, lentils or vegetable mixes you made the day before are good to go so long as they are still fresh and edible.

• Lemon juice 2 tsp • Sugar 1 tsp • Paprika powder 1/2 tsp • Mustard paste 1 tbsp • Garlic paste 1/4 tsp • Salt 1/4 tsp • Cumin seeds (ground) 1 pinch

Switch up the toppings: Everyone loves lettuce and tomatoes for the freshness and crunch they add to a sandwich but they are, unfortunately, almost entirely water and prone to wilting. And what’s more, the moisture they release makes the bread even more vulnerable to sogginess. How about replacing them with some other vegetables that will offer the same benefits? For instance, roasted peppers are a great alternative for tomatoes as they add spice to the sandwich without moisture. Spinach, cabbage or even cucumbers can be used to replace lettuce and they taste so good, you won’t even feel the difference!

• Thyme (dried) 1 pinch Give the final touch: Seasoning isn’t just for the stove-top! It can make as much of a difference to a simple sandwich as to any other food item. Good old salt and pepper can liven up the blandest of meals. You can also try adding fresh herbs like basil leaves or coriander for additional flavour.

Woman of the week 8

During a shoo t.

At an event.

Fashion Designer

At Fashion Pakis tan Week.

Design by Maryam Rashid

No matter how much we love it, applying and wearing make-up can be tiring.

From putting on the base to the last bits of mascara, the process can make or break your look for the day. And it’s even worse when the make-up fades off, despite us having put so much effort into it. Concealers and foundation, in particular, tend to blend away during the course of the day, making us rush to the loo for touch-ups lest we look tired and dull.

The purpose of a concealer, as its name suggests, is to conceal dark spots and even out the skin tone. A good concealer can liven up our complexion like no other and many of us are guilty of using it as a complete base, instead of foundation. But funnily enough, most of us are also still unaware as to what the

correct method for applying is. According to make-up big-weights like French artist Laura Mercier, concealer isn’t meant to be smeared (as most of us do) but dabbed instead.

So if you want to look gorgeous like Alist celebrities who Laura styles, apply your concealer by tapping it onto the problem areas of your face and patting it in with the pads of your fingers. Keep patting until the entire product has been absorbed into the skin completely and the area you wish to correct is covered. Smearing it causes the concealer to go to waste and fails to procure the desired coverage and long-lasting effect we want. In fact, to make things simpler, follow these four steps for expert results and up to 14 good hours without touch-ups!

Step 1: Always start with a fresh, clean face.

Step 2: Take some concealer on the pad of your index finger and create five spots in a V-shape on the problematic area.

Step 3: Blend the dots in by tapping lightly, all the while maintaining the V-shape in movement.

Step 4: Once the concealer has blended in completely, brush a light dusting of finishing powder to set it in and lock the moisture.