The Express Tribune hi five - March 8

Ms MARCH 8, 2015

ISSUE NO. 142

The blood battle:

A guide to thalassemia

2

page

Polygyny — sunnah or desire?

6

page

inside En vogue — A touch of drama

Domestic goddess —

Stir-fry prawns

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

8

page

The melodious Komal Rizvi

2

Ms

By Ishrat Ansari

The buzz

|

THE EXPRESS TRIBUNE, MARCH 8, 2015

Design by Hira Fareed

As a mother, nothing could be more painful than to see your child infused with cannula lying in bed.

Asma Jawwad, a 25-year-old mother, has watched her three-year-old son Wahab go through the pain every month ever since he was a toddler.

Wahab was diagnosed with thalassemia when he was seven months. He inherited the blood disorder from his thalassemia minor parents. Unfortunately, Wahab is not alone in his struggle and shares his fate with over 100,000 Pakistanis, according to the Omair Sana Foundation (OSF). Moreover, according to the World Health Organisation, an estimated 300,000 babies in the world are diagnosed with severe haemoglobin disorders annually.

Thalassemia is a hereditary blood disorder that prevents the production of haemoglobin — the protein in red blood cells which carries oxygen to all parts of the body — leaving the patient anaemic.

Therefore, anyone afflicted with the disorder needs regular red blood cell-infusions.

According to data released in 2013 by medical experts, thalassemia has been on the rise in Pakistan with over 5,000 babies born with the disease each year. The problem persists because most people are never diagnosed on time and carry on living a normal life by crediting anaemia to lack of iron in the body. The only way to discover if you have the thalassemia trait is to take a special blood test called haemoglobin electrophoresis which can identify the gene.

On the other hand, thalassemia major is detected in early childhood and requires regular blood transfusions to maintain an adequate supply of haemoglobin. Due to multiple transfusions, however, the organs become severely overloaded with iron causing the patient to become vulnerable to many diseases, such as Hepatitis C and heart failure. A specific treatment is therefore needed to manage the condition. “Around 60% to 70% of children born with the disorder succumb to Hepatitis B or C before reaching the age of 10,” says Dr Salman Naseem Adil, associate professor

at the section of Haematology at Agha Khan University Hospital, Karachi. And if both a man and woman are carriers of thalassemia minor, they are at a 25% risk of having a thalassemia major offspring, he adds.

For Asma, the ordeal was to abort a child as both she and her husband Jawwad were carriers of thalassemia minor. “After the first two miscarriages, my third pregnancy was nothing less than a blessing but my child was diagnosed with thalassemia during my second trimester which left me with little option but to abort the pregnancy,” recalls Asma.

Moreover, some thalassemia minor parents have to take extreme measures to safeguard their unborn babies from becoming vulnerable to the disorder. For Rahat Muhammad, a thalassemia minor carrier who lost her 16-year-old son to the disorder, the only option left was to undergo sterilisation — a permanent procedure to prevent pregnancy — after having five children, two of whom were diagnosed with thalassemia major and one with thalassemia minor. Her 13-year-old daughter, Hajra, who stands in line for blood transfusion at OSF says, “I love going to school but my feet and head hurt and I often get sick.” Rahat and her husband later took the test and were both diagnosed with thalassemia minor.

THE EXPRESS TRIBUNE, MARCH 8, 2015

3

With increasing numbers, the only logical solution towards eliminating the disease, according to Dr Saqib Ansari, a pediatric haematologist at the National Institute of Blood Diseases, is to create awareness among the masses. “A simple test can help us save lives and prevent marriages between two carriers,” explains Dr Ansari. According to Dr Adil, however, “Through blood transfusion children can live normal lives. The main issue, however, is affordability because it costs Rs8,000 per month for blood transfusion.” Children in villages and remote areas succumb to the disease because of poverty and lack of health facilities, he adds.

Although the Thalassemia Bill — making blood screening mandatory for couples before marriage — was passed in 2014, there is no implementation. “The disorder is spreading owing to intra-family marriages,” says Dr Ansari, who suggests that the test should be taken before getting a CNIC or B-Form made. To make this a reality, there is a need for Thalassemia Centres to be opened up across the country as currently there are only a handful of them, he adds. “Approximately Rs80 million is required to set up a centre,” states Imtiaz Ahmed Malik, the coordinator at OSF. “The government may not have the expertise but they can at least provide funds to reduce the number of children born with the disorder,” he adds.

Another major challenge towards reducing thalassemia cases is countering the stigma surrounding abortion. In case a couple is diagnosed with the disorder after marriage, the next best alternative is to conduct a Chorionic Villus Sampling (CVS) during pregnancy. CVS tests the foetus for thalassemia and in case it turns up positive, abortion should be recommended.

“Countries such as Iran and Saudi Arabia permit abortion in case the foetus is diagnosed with thalassemia major,” says Dr Adil. “This has helped them decrease the number of patients, but in Pakistan abortion is still considered a taboo.” Over the course of eight years, from 2006 to 2014, OSF has conducted 2,000 prenatal tests and found that 99% couples agree to opt for abortion while one per cent refuse owing to religious beliefs. “Couples agree to abort their baby once we state the problems it will face after birth,” says Dr Ansari. “The lack of awareness becomes a hindrance, hence there is a dire need to transmit knowledge and information about the issue,” he adds.

Unfortunately, blood-transfusions, the only treatment course for patients, are also not readily available in the country. According to Malik, around 1.5 million bottles of blood are required annually for this and voluntary blood donation is less than one per cent. “People are very reluctant to donate blood and it’s not easy to find donors,” expresses Dr Adil. On the other hand, flawed screening of blood puts children at a risk of being infected with diseases such as HIV or hepatitis. Last year, Thalassemia Federation of Pakistan reported that 10 children, between the ages of 5 and 16, tested positive for HIV after receiving a transfusion with infected blood. Considering blood is life for thalassemia patients, perhaps this is where the country needs to start. Malik suggests spreading awareness about the importance of donating blood. But more important than managing the disease is to force couples to take the test for thalassemia and prevent the silent killer from taking another innocent life.

4

Ms

En vogue

Showstopper’s latest ethereal collection will wake up your inner drama queen.

Coordination: Umer Mushtaq Hair and Make-up: Angie Marshal Label: Showstopper Photography: Khawer Jadoon Model: Maha Kanwal

THE EXPRESS TRIBUNE, MARCH 8, 2015

THE EXPRESS TRIBUNE, MARCH 8, 2015

5

6

Ms

Lifestyle

THE EXPRESS TRIBUNE, MARCH 8, 2015

By Mehreen Ovais or a very long time, a woman has wondered about the reason behind her man’s decision to wed another woman. Owing to the conservative and patriarchal society we live in, her question is often silenced and religion is brought into the discussion. But what Islam permits is often quoted adversely, giving the man the right to multiple marriages. Polygyny — the practice of having more than one wife — is the narrow form of polygamy (having more than one spouse). Islam allows a man to have more than one wife at one point, with a maximum of four — a provision that has been largely misunderstood and abused by the society.

The purpose of polygyny in Islam, according to scholars, was to protect widows and orphans.

“The Prophet (PBUH) regarded monogamy as a most rational and practical form of marriage contract,” says ZM Shahid Siddiqi, an author who writes on cultural and legal matters.

“Polygyny was permitted under exceptional circumstances, demanding the fulfilment of conditions which are generally impossible to satisfy,” he adds.

Polygyny, therefore, is not intended to serve the personal desires of men. In fact, it is sanctioned under circumstances such as war and natural calamities when the ratio of women to men increase and a majority of women and children are left without support and shelter.

Even in that scenario, Islam lays out strict rules. Foremost, the previous wife/wives need to consent to the new marriage and the man needs to ensure that he can be absolutely impartial and equitable in dividing his resources, time and affection amongst all his wives.

In Pakistan, however, polygyny for some is a norm practiced through generations. “I am the first of my husband’s three wives and it is a norm for men in my family to marry more than once,” explains Nusrat Wahid, a resident of Lahore. “I had no option but to accept my husband’s later marriages.”

Over time, polygyny has become a normalised practice in Pakistan. According to Rafia Zakaria, an attorney who teaches constitutional law and political philosophy, polygyny is often quoted as a male’s prerogative or a solution to a variety of societal ills. The reasons cited for subsequent marriages are mostly sexual desire, financial gain or personal pleasure. The second wife is often the one who is more glamorous, younger or is said to have better social graces. It is rarely ever the case that a man is equally fair to all his wives and children and for Nusrat, a small amount of monthly pocket money is all that she gets from her husband. She is expected to be content with having a home for herself and her children. “My in-laws tell me that it is my husband’s right as a man to keep multiple wives and that I should be grateful he did not divorce me,” she says.

|

Design by Eesha Azam Findings from a recent study carried out by Dr Rana Raddawai, associate professor at the American University of Sharjah’s English department, polygyny can result in feelings of neglect, abuse, depression, jealousy and unhealthy competition between wives. Dr Rana studied 100 Arab women in polygynous marriages and concluded that financial, emotional and psychological neglect was largely prevalent in all cases.

Another study by the Malaysian group Sisters in Islam in 2010 highlighted that polygynous marriages not only affect the wives but the children as well as they are often neglected by their fathers, both financially and emotionally, and begin to harbour feelings of bitterness, anger and hostility.

Naila Ali, a homemaker in Rawalpindi, lives in the same home as her husband’s other three wives and his 15 children. “Quarrels and resentment are a daily part of our lives,” she complains. “My husband doesn’t concern himself with household matters. In fact, he doesn’t even know the names of all his children!”

Family law in Pakistan, with its flaws in design and execution, does little to help the situation. The Muslim Family Law Ordinance of 1961 demanded that marital practices should be made more transparent. With regards to polygyny, it was made mandatory for a man seeking a second wife to get permission from an Arbitration Council and the existing wife. However, this stipulation is often ignored. The Institute of Policy Studies (IPS) task force in Islamabad looked at the legislative structures between 2008 and 2010 and found them to be incongruent and weak. As per the findings, the law only penalises the person who violates the consent clause but the marriage itself is not invalidated.

On the flip side of the coin, there are a number of arguments for polygyny and the entire concept has been repackaged to suit cultural and social beliefs. According to IPS, the Federal Shariat Court states that if polygyny is not permitted, all manners of moral decadence and degeneration — from prostitution, sex out of wedlock to homosexuality — would be tolerated.

Some activists argue that polygyny should be allowed in the spirit of the original principles of Islam in order to facilitate divorced and widowed women. Limiting polygyny would violate the rights of women where a person wishing to marry another woman would have to divorce the existing wife. While most scholars, thinkers and reformers favour monogamy, Zakaria calls for an active feminist movement as a counter measure to arguments in favour of polygyny. But till that movement strengthens, there must be an effort on the part of women to be conscious of the clause in the nikhanama that deals with polygyny, so they are able to protect their positions and rights.

Polygynous marriages not only affect the wives but the children as well as they are often neglected by their fathers and begin to harbour feelings of bitterness, anger and hostility

Domestic goddess 7

THE EXPRESS TRIBUNE, MARCH 8, 2015

By Huba Akbar

Stir-fry prawns

If you are craving a quick taste of oriental cuisine, this recipe is for you!

Ingredients • • • • • • • • • • • • • • • • •

Prawns 1/2 kg Cornflour 1 tbsp Oil 4 tbsp Green chilies 5 Capsicum 1 Carrot 1 Onion 1 Chili garlic sauce 2 tbsp Chili sauce 2 tbsp White vinegar 2 tbsp Soy sauce 1 tbsp Tomato ketchup 3 tbsp Pineapple juice 1/2 cup Roasted cashew nuts (cut into half) 6 Salt to taste Red chili flakes 1/2 tsp Black pepper 1/2 tsp

Method • Season the prawns with salt, red chili flakes, black pepper and cornflour.

• Heat about three tablespoons of oil on high flame and stir fry the prawns for five minutes or until they are cooked through. Once cooked, take them off of heat and set aside.

• Heat one tablespoon of oil in the same pan and sautée the green chilies, chopped capsicum and carrot for two to three minutes on high flame.

• Stir in the onion and salt and continue cooking the vegetables until the onion becomes soft. Make sure not to overcook the vegetables — they should remain crunchy.

Prawns and cholesterol Although prawns (commonly known as shrimps) are known to be high in cholesterol, they are otherwise quite nutritious and not necessarily off limits to cholesterol-conscious eaters. The amount of cholesterol stored in a body has a direct link to cardiac health: the higher the cholesterol level, the greater the risk of coronary heart diseases, heart attacks and strokes. Low Density Lipoprotein (LDL) in particular is a very harmful form of cholesterol that can accumulate inside the arteries and combine with other substances to create thick, hard plaque. This is dangerous as the plague can cause the arteries to stiffen and become narrow, eventually leading to blockages.

In general, shrimps are relatively low in calories. For instance, 3.5 ounces of shrimp contains 99 calories, 24 grammes of protein and 0.3 grammes of total fat. But when it comes to cholesterol, the same 3.5 ounces of cooked shrimp carries about 189 milligrammes of cholesterol! The good news is that according to New York University’s Langone Medical Center, the effect of cholesterol on LDL levels isn’t as great as that of saturated and trans fat. It is for this reason that most low-cholesterol diet focus on reducing one’s consumption of saturated fats, instead of cholesterol directly.

The final verdict is that prawns are perfectly healthy for those with cholesterol problems so long as they don’t overindulge themselves. Doctors prescribe limiting cholesterol intake to no more than 200 milligrammes per day to remain on the safe side. It is also important to maintain a nutritious and balanced diet along with the prawns to keep cholesterol at bay.

SOURCE: LIVESTRONG.COM

Try some herbed rice Serve the prawns with herbed rice for the ideal oriental experience!

Ingredients: • Water • Rice 2 cups • Chicken cube 1

• Thyme 1 tsp • Oregano 1 tsp • Butter 1/2 cup

Method • Add water, one chicken cube and half of the butter to a large stock pot and bring them to boil.

• Once the liquid is ready, add rice and one teaspoon of crushed oregano and thyme with the remaining butter.

• Cover the pot and allow the rice to simmer for approximately 30 minutes.

• Pour in the chili garlic sauce, chili sauce, soy sauce, ketchup, pineapple juice and white vinegar and mix thoroughly.

• Add the roasted cashew nuts and fried prawns to the pan and stir. Your prawns are now ready.

• Remove the pot from heat and let the rice sit for a few minutes before serving.

HERBED RICE PICTURE COURTESY: WWW.THEKITCHENSNOB.COM

Woman of the week 8

Getting read y for a

wedding.

Singing ‘Adele’ at Mohatta Palace.

Singing ‘Tu beh gaya’

at Media Meet Up .

Have you been having trouble sleeping and suffer from its impending effects the next morning? Does your mind take off in all directions the moment you hit the sack? If yes, you might be dealing with anxiety without even knowing it!

According to Steve Orma, a clinical psychologist based in San Francisco, anxiety tends to disrupt our sleep and cause insomnia. But of course, we already knew that. The big news is that since anxiety is actually triggered by one’s own thoughts and emotions, there are ways you can think your way through and get some much-needed sleep. Just follow these simple steps that’ll help alleviate your anxiety. They are free, easy and devoid of any side effects!

Shed the negativity: Anxiety is often caused by stressors which are things that we — knowingly or unknowingly — might be worried about. The first thing is to try and identify your stressors. At times, insomnia may be caused by the fear of insomnia itself. At other times, there might be something in your personal or professional life that you aren’t satisfied with. Identify whatever it is that’s bothering you and start resolving the matter.

Most people consider it easier to stay in bed and wait for sleep to come but Orma begs to differ. “Because they are still in bed, people start to subconsciously associate being in bed with being awake,” he explains. This means that lying down becomes counterproductive and can actually make you more anxious about not being able to fall asleep. The ideal thing to do is to get up, walk around or change rooms if you wish.

According to a research carried out by the Journal of Psychological Science, if your mind is filled with negativity and stressors (job, relationships or other things) then address the worries in physical form and throw them away. Write them down on something tangible and then throw it away or deal with it the next day. Another good way to release frustration is by working out. Exercise also tires one out mentally and physically, making it easier to fall asleep at night.

Most people assume that having a set bedtime will condition their body to rest when that time comes. While this indeed helps some people, having a nighttime routine doesn’t always come that easy. In this case, it might not be anxiety keeping you up but the fact that you are not tired enough to fall asleep. Changing your bedtime may take an hour off your schedule but will definitely guarantee better sleep.

If all else fails, try reading a book, drinking some green tea, listening to music or practicing meditation. You must, however, stay away from your phone or laptop and TV sets as the blue rays will only keep you up for longer. Moreover, anxiety and insomnia are normal and treatable so don’t worry about your condition. If it persists, seeking professional help might prove fruitful.

Design by Eesha Azam