The Express Tribune hi five - June 29

Ms JUNE 29, 2014

ISSUE NO. 106

Pretty in Pastels

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page

Aid for AIDS page

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inside the fast challenge —

Fasting for the pregnant and nursing mother in Ramadan

domestic goddess — Moroccan madness

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Section In-Charge: Sarah Munir Sub-Editor: Amna Hashmi

The Creative Genius - Maha Burney

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Ms

the buzz

THE EXPRESS TRIBUNE, JUNE 29, 2014

The AIDS by Mehreen Ovais

Debate

Have Pakistanis finally woken up to the harsh reality of HIV/AIDS and what are they doing about it?

In last year’s critically-acclaimed biopic Dallas Buyers Club (DBC), Hollywood heartthrob Mathew McConaughey gives a grittily truthful performance as Ron Woodroof, a rather unscrupulous, working-class American diagnosed with advanced Human Immunodeficiency Virus (HIV) during the HIV/AIDS epidemic of the 1980s. Having been denied medical assistance, Woodroof finds himself travelling the world to acquire pre-approved, illicit drugs to help ease his condition and to sell them to fellow patients who cannot access proper care. After a prolonged legal struggle with the Food and Drug Administration (FDA) and the US National Institute of Health, Woodroof finally manages to have Peptide T – an experimental HIV inhibitor – approved for importation.

But while the world went ablaze with appreciation for McConaughey’s artistry, few realised the social implications that the movie highlighted: a general lack of compassion towards HIV in ’80’s America. Based on a true story, DBC is an adequate representation of the discrimination HIV patients faced everyday as a result of the disease being attributed mainly to drug-addicts and sex-workers. They were ostracised by their families, expelled from classrooms and laid off from their jobs. Misconceptions regarding the infection being transmittable by touch discouraged many doctors from helping patients lest they contract it as well.

Although the world has improved its attitude towards HIV over the past two decades, the improvements have been sporadic in comparison to the spread of the infection. In Pakistan, HIV still remains somewhat of a social taboo, partly based on the notion that it possibly cannot exist in a conservative society like ours. In contrast, a study conducted by the UNAIDS programme in 2012 shows that there are approximately 1, 60,000 people living with HIV in Pakistan, with the prevalence rate highest amongst women and young adults. “Until recently, Pakistan was classified as ‘low prevalence high risk’, but now it is in the ‘concentrated phase’ of the HIV epidemic,” says UN official Shafeeq Rehman. “Up to 5% people suffer from the infection now, in at least eight major cities.” Despite this,

people remain unaware of HIV and its impending repercussions.

“HIV infects the cells of the immune system such that the patient develops impaired cell-mediated immunity,” says Dr Shaukat Ali Sheikh, a surgeon at the Islamabad Medical and Dental College. It germinates as a common cold with standard flu-like symptoms, the only difference being that the symptoms don’t subside due to the weakened immune system. From here, the virus can seep into the body fluids and spread via blood-to-blood or sexual contact. In some instances, it can pass down to newborn babies via pregnancy and while feeding.

A person diagnosed at 20 can expect to live up to 70 – the same lifespan as a non-patient HIV Specialist and Founder of the World Health Clinicians Dr Gary Blick The HIV virus attacks the immune system, destroys its cells and multiplies rapidly, thereby becoming a permanent condition. Over time, it can destroy the immunity cells so thoroughly that the human body is unable to counter other infections and diseases anymore, leading to Acquired Immunodeficiency Syndrome (AIDS). “Under these circumstances, even the most minor infections become very serious,” adds Dr Shaukat. “The transition from HIV to AIDS can take a few months or even up to 10 years.” If not managed properly, HIV can lead to other infections like tuberculosis, cancer and neurological disorders.

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THE EXPRESS TRIBUNE, JUNE 29, 2014

People wouldn’t have lunch with me or shake my hand or even talk to me. I could tell I was constantly gossiped about and there were many negative assumptions cast upon my character which worsened my health a lot more than my HIV did HIV Patient Asim Farrukh One must note that there are many other factors that can cause the infection to spread, coitus being just one of them. According to a study conducted by Dr Yasmin Bhurgri from the Department of Pathology at Aga Khan University Hospital, out of all patients diagnosed with HIV/AIDS during 2006, about 11.73% of the cases had caught it due to contact with contaminated blood or blood products (used syringes, needles and sundry medical/dental equipment). Other modes of transmission including Injecting Drug Use (IDU) contributed to 2.02%, abnormal and unsafe sexual activity at 4.55% and mother-to-child transfer at 2.2%.

Transmissions of unknown origins comprised about 26.9% of all cases.

Although there is no medication that can reliably eliminate the HIV virus within, there have been substantial advances in treatment and therapies that have improved the lives of people with HIV greatly.

Scientists have developed drugs which can successfully curtail the growth of the virus, if not rid of it altogether. Various vaccines are being developed and tested across the world and it is expected that we will have access to effective immunisations by the end of the decade.

It can be argued that a major factor which discourages people from opening up about HIV is the fear that AIDS is incurable and fatal, offering no opportunity for a normal life. “On the contrary, a person diagnosed at 20 can expect to live up to 70 – the same lifespan as a non-patient,” explains Dr Gary Blick, HIV Specialist and Founder of the World Health Clinicians.

Under careful monitoring, patients can lead a normal life and even reproduce without running the risk of passing on the infection.

There are many fallacies which surround HIV/AIDS and fuel the discrimination surrounding it. As mentioned earlier, many patients are cast out by society for contracting AIDS – a disease they connect to stigmatised behaviours like drug abuse and promiscuity. Many like, 17-year-old student Ibrahim Gilani believes, “People who have AIDS bring it upon themselves as they can’t control their emotions. If they hold multiple relationships with different partners, they deserve to be sick.” Natasha Rahim from Rawalpindi reiterates Ibrahim’s perceptions by sharing the story of her neighbour who was shunned from his home for catching AIDS. “When the inhabitants of our town found out about his illness, they physically and psychologically forced him to pack up and leave,”

she shares. “Everyone called him disgusting and immoral and attributed his fate to moral weakness and karma.” It is also wrongly believed that the HIV virus can spread via casual contact, such as sharing cutlery or lavatories.

The example of Asim Farrukh lends credence to the fact that HIV and AIDS are still frowned upon in Pakistan, due to prevailing misapprehensions. Upon diagnosis, which was actually the result of a poorly conducted dental treatment, Asim was let off from his job at a local bank. “There was so much hostility from everyone at my office,” he recalls. “People wouldn’t have lunch with me or shake my hand or even talk to me. I could tell I was constantly gossiped about and there were many negative assumptions cast upon my character which worsened my health a lot more than my HIV did.” Similarly, 24-year-old Mariam Hasan was divorced and thrown out by her own family after she contracted HIV following a surgical procedure involving unscreened blood. “Even though my disease isn’t contagious, I hide it from everyone because no one really understands.”

Unfortunately, AIDS-related discrimination prevents people from speaking about their conditions and hinders general awareness. “We have to be extra careful when conducting awareness campaigns or visiting homes to speak about HIV/AIDS,” admits social-worker Halima Shan. “Many times, we are accused of trying to brainwash local women and promulgate wrong, sinful ideas in society. Some families have extremely strong opinions regarding the topic and ask us to leave.” Fear of rejection and confidentiality concerns also discourage people from having themselves tested, meaning that they might spread the infection unknowingly. Such was the case of Farkhanda Inam, a domestic worker who was unaware of her disease until after marriage. “My husband didn’t know he had AIDS and neither did I,” she confesses. “I was devastated [to know] that he had other partners before me, but the fact that I have to bear the consequences for the rest of my life made it worse.”

Up to 5% people suffer from the infection now, in at least eight major cities UN official Shafeeq Rehman Over the years, considerable efforts have been put into creating awareness about HIV/AIDS by individuals, non-profit organisations and doctors so that the disease can be prevented or treated in time. One such example is the Association of People Living with HIV in Pakistan which has been providing support to patients ever since its establishment in 2006. Shafeeq remains hopeful, saying that, “Pakistan still has a window of opportunity as according to current estimates, HIV prevalence is still below 1%.” This allows for ample time to educate the masses about the disease and how they might be able to prevent it. The situation may appear bleak but the right steps can lead us to an AIDS-free life and the efforts of Ron Woodroof will not become futile.

HIV 101 Symptoms of HIV • Fever (most common occurrence in HIV patients) • Swollen glands • Rashes • Sore throat • Fatigue • Muscle and joint pains • Frequent headaches

How Does HIV Spread • Indiscriminate transfusion of unscreened blood • Non-sterilised medical and dental equipment • Reuse of old or used syringes and needles • Sharing of needles and syringes (as in IDU cases) • Unhygienic equipment used by barbers and beauty parlours (razors and scissors, etc) • Unsafe sexual practices • Lack of awareness and education regarding health matters

4 Ms

en vogue

Fashion for the

Couture Queen Ayesha-Somaya’s latest semi-formals are ideal for the upcoming summer Eid

Label: Ayesha-Somaya Collection: Summer 2014 Luxury Pret for Eid Model: Sadaf Kanwal Photographer: Amna Belal Styling & Art Direction: Amna Belal Hair & Makeup: Nabila N Pro

THE EXPRESS TRIBUNE, JUNE 29, 2014

THE EXPRESS TRIBUNE, JUNE 29, 2014

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Ms

the fast challenge

THE EXPRESS TRIBUNE, JUNE 29, 2014

A Balancing Act xxxxxxx xxxxxx xxxxx xxx xxx xx

by Nisma Chauhan

The challenge of fasting for pregnant and nursing women The month of Ramadan is here and for women who are currently pregnant or nursing, it can prove to be quite a challenge. Also, the fact that this year Ramadan falls right at the heart of summer, with an average daily fast of 15 to 18 hours, doesn’t help much.

There are many misconceptions women have regarding fasting and how it can adversely impact their infants and foetuses. Many expecting and lactating mothers are quite vary of fasting during this phase in their lives which discourages them from it. Housewife and mother-of-four Bisma Shahid, however, alleviates these false notions. “Ramadan never concerned me during my pregnancy or nursing days,” she shares. “My youngest child is now a year and half but refuses to eat anything I try to feed her. Hence, she is entirely dependent upon nursing. Yet, I do not intend to skip any of my fasts so long as I am eating enough for her to remain healthy.”

Fortunately, there are some measures mothers can take to keep all their fasts without compromising on their health and that of their children. Sana Azfar, a consultant nutritionist at Imam Clinic Karachi, suggests some guidelines women can follow in order to maintain their required intake of proteins, irons and calcium during Ramadan. “Both pregnant and nursing women must increase their consumption of liquids during the month,” she says. “They should take at least two dates each, both at Sehri and Iftaar and once they have opened their fast, they should wait until later to eat dinner. Late dinners can help control indigestion and acidity in pregnant women.”

Additionally, Sana recommends drinking a lot of water and eating fruits which will maintain the water level among lactating mothers and help them sustain their fast.

Bisma, who feeds her daughter at least four times a day, follows Sana’s advice and indulges in lots of milk, juices and water before and after her fasts. More importantly, however, she advises women not to reduce the hours of lactation during Ramadan. “My 11 years worth of parenting experience has taught me that mothers shouldn’t stop or reduce nursing while fasting. It leads to related health problems.”

According to Dr Tayyaba Arshad, a gynaecologist Nargis

Hospital and Maternity Home, most patients prefer to continue fasting. “The only time I would advise a mother to skip her fast is when and if the foetus or baby is suffering from Intrauterine Growth Restrictions (IUGR), a condition wherein the baby is smaller than it should be,” she says. In such cases, the baby requires as much nutrition as possible and fasting will only hinder that. “Mothers suffering from diabetes, high or low blood pressure and Urinary Tract Infections (UTI) should also avoid fasting as these problems require regular medication,” she adds.

Nonetheless, it is mostly anaemic women or those with a history of health issues, like multiple miscarriages, who are likely to face complications during pregnancy. “I would recommend two boiled eggs or wheat porridge for Sehri to fulfil the daily protein intake,” says Sana. “If one does not feel hungry, for hormonal or any other reasons, they should consume liquids to regulate sugar levels. Dinner should include a chappati for iron. Also, mothers should take nutritional supplements to boost their well-being,” she adds. Dr Tayyaba prescribes 10 microgrammes of Vitamin D for gestation and lactation, two times a day. Both experts also emphasise on drinking a lot of water to avoid dehydration.

Mariam Arsalan, a 26-year-old mother, highlights the importance of eating cautiously during Ramadan. “I kept all my fasts during my first pregnancy and managed to get past without any complications,” she shares. “I focused on healthy foods like fruits and green vegetables and cut down my daily household chores to avoid stress.” This Ramadan, Mariam is in the midst of her second pregnancy and following the same diet, coupled with bed rest and 30 minutes of brisk walking daily.

Mothers should, therefore, make an informed decision when it comes to fasting. Consulting a doctor beforehand is imperative so that any unknown infections or health issues can be detected and treated early on. While it is perfectly alright to fast during pregnancy or nursing, one must take all necessary measures to ensure that the health of both mother and child is not compromised.

domestic goddess

THE EXPRESS TRIBUNE, JUNE 29, 2014

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Recipe

Moroccan Chicken Pita Wraps Smoked chicken, vegetables and pita bread get a Moroccan touch with lemon juice and chilli in this recipe for delicious wraps. Addiction guaranteed!

Method • Mix together the dry ingredients and pour in lemon juice. Adjust the taste if required.

• Add 1 tsp of olive oil to form a paste of the dry ingredients.

• Marinate the chicken strips in the paste for about 30 minutes (or overnight).

• Fry the chicken on a grill or in a pan for about 10 – 15 minutes, until it is cooked thoroughly.

• Toast the pita bread in the oven for 2 -3 minutes (on each side) • Place the chicken strips in the centre of the pita bread and garnish it with the chopped onions, tomatoes and chillies.

• Roll the pita bread into a wrap. Your dish is now ready!

Note: • Hummus can be added to the wrap for extra dressing.

• The chicken strips can also be grilled and served without the pita bread.

Seemi Aamir is a part-time teacher and mother of three who spends much of her free time trying out new recipes and creating her own

Ingredients:

Boneless chicken breast (cut in 1-inch strips) 2

Paprika 1/2 tsp

Cumin powder 1/2 tsp

Freshly squeezed lemon juice 1 lemon

Ginger garlic paste 1/2 tsp

Salt 1/2 tsp

Black pepper 1/2 tsp

Red chilli flakes 1/2 tsp

Olive oil 1 tsp + 1 – 2 tsp for frying

Pita bread 2–3

Onions (small) 1

Tomato (small) 1

Green chilli (chopped) 3 - 4

woman of the week 8

THE EXPRESS TRIBUNE, JUNE 29, 2014

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