Dr. Aisha Mehnaz is combating child abuse—particularly sexual abuse, a hidden agenda in Pakistan—through education and advocacy, and by shifting the responsibility for children’s healthy development beyond the immediate family to include doctors, teachers, and others in the community.
The New Idea
Aisha is addressing the problem of child abuse in Pakistan by enabling society—parents, doctors, schoolteachers, lawmakers, politicians, religious leaders and others—to break the taboo of discussing abuse and take concrete actions for its prevention and proper treatment. Aisha has developed a model that revolves around early detection of cases and an infrastructure to address measures for protection, prevention, and rehabilitation. The model brings together public education and advocacy through media and through networking between the Pakistan Pediatric Association (PPA), local hospitals, legal and social professionals, and various citizen organizations committed to reducing child abuse. Aisha has developed a training program for schoolteachers, parents and medical workers in order to raise their awareness about the issue and pry open the conversation at the societal level. To improve treatment of abuse, Aisha is creating Child Protection Committees in the hospitals. Participating doctors are trained to diagnose and register the child sexual abuse cases in ways that are most sensitive to children’s psychological needs and privacy. Each CPC is also meant to motivate parents or family members to register cases, learn basic ways to prevent further incidents of abuse, and learn how to help children deal with the trauma. In cases where parents or families are the primary perpetrators of abuse, the CPC welcomes children as a safe space where they can get support and begin a path of recovery that will enable them to once again trust those closest to them. In addition, Aisha has begun a campaign against corporal punishment in schools and homes to reverse the cultural norms that currently view physical violence an acceptable form of discipline.
Pakistani society is finally coming to terms with the prevalence of child abuse, especially that perpetrated by relatives and friends of the family. Physical punishment in schools and in the home is widely accepted as normal disciplining. Meanwhile, despite its frequency, sexual abuse remains a taboo issue and is rarely reported in order to preserve family honor. In such a culture, both forms of abuse become normalized, and their physical and psychological impacts go unaddressed.
Nearly half of Pakistan’s population is below 18 years of age. According to unofficial data, 21 percent of children suffer from sexual abuse and 30 percent are suffering from nutritional neglect. Corporal punishment is extremely common in school and madrasahs. Young children being increasingly involved in labor, beggary, trafficking, prostitution, and as soldiers or even suicide bombers. This perception of children as “resources” must change for the health of Pakistan’s future; society must take responsibility for the proper development and treatment of its children, because its children are its future.
As a medical doctor specializing in pediatric care, Aisha recognized how few doctors were equipped to deal effectively with obvious cases of child abuse. The main problem was that doctors, just like parents and guardians, were burdened with cultural norms of preserving family honor despite the visible physical and psychological suffering of their young patients. To make matters worse, the bureaucratic legal procedure for reporting cases of abuse discouraged reporting further. Many doctors were well aware that as whistleblowers they would risk losing their credibility in their communities and thus losing their work.
In addition, just like doctors, schoolteachers come into regular contact with children and can thus easily spot cases of abuse and neglect. However, despite their willingness to contribute, they again have felt powerless to do so as deep societal norms place such responsibility in the hands of parents and guardians alone.
Aisha began advocating for the prevention and treatment of child abuse through the Pakistan Pediatric Association (PPA) in the mid-1990s where she used the platform to advocate for giving equal preference to children’s pleas on abuse against the word of elders. From early on she saw this as a key tipping point for coming to terms with the prevalence and destructive effects of child abuse: until schoolteachers, doctors, relatives, and more formal legal entities believed what children reported—and resisted cultural pressures to preserve family honor—progress was unlikely. Recognition of the problem was a necessary step towards recovery, and despite the obvious signs and calls for help, society was turning a blind eye. In cases of sexual abuse in particular, taboo was working against the interests of children and against workable solutions. Aisha’s strategy is thus to break the taboo first, and then establish the proper mechanisms to reduce future incidents of abuse and to give children the proper care they need to recover from their trauma.
In 2004, to take the message of child abuse prevention to the masses, Aisha established Konpal: Child Abuse Prevention Society in Karachi. Konpal began as a group of volunteers with two staff members and a small budget raised mainly through donations. Through Konpal, Aisha organizes training programs for parents, schoolteachers, paramedics, medical practitioners, and the general public on all issues related to child abuse and neglect. Konpal also produces a monthly newsletter to create awareness among the civil society organizations and media about child health care and ways to prevent or report child abuse. In 2005, following the initial round of training sessions, Aisha established the Child Protection Committee (CPC) at Civil Hospital Karachi to respond to the service need generated by the trainings—in just a few months, the number of reported abuses had risen dramatically. The same year she motivated doctors in three other hospitals in Karachi and Hyderabad to establish CPC.
In 2006, Aisha started working with orphanages and boarding schools to prevent corporal punishments and abuse. More recently, she began to work on eliminating corporal punishment in Pakistani religious schools. Through Konpal, and with support from UNICEF, Aisha has since 2006 begun to spread her program throughout Karachi and across Pakistan. Konpal is a member of a select group of COs in Pakistan that specifically works on preventing child abuse. She is using the network to spread the message across Pakistan and internationally. She continues to take graduate and undergraduate courses on detection and treatment of child abuse cases so that she can be most effective when raising media awareness or when working directly with schoolteachers, families, doctors and children.
Finally, Aisha has been instrumental in the drafting of a National Plan of Action to eliminate child abuse. She is now lobbying for its implementation using talk shows on television channels, organizing walks and conferences and directly talking to policy makers through a network of organizations at the national level. As much as possible, she seeks voluntary buy-in from families, doctors, religious leaders, and lawmakers, recognizing that reduction of abuse will take a shift across society as more people take responsibility for Pakistan’s children. She is organizing a national conference on child rights and abuse in 2010.
Aisha graduated as a medical doctor in 1982 and joined the Public Health School in 1983 as an instructor for Lady Health Visitors. She started her career in Dow Medical College as Resident Medical Officer for patient care and a year later became a professor in the same school. Aisha had the good fortune to work with Dr. Ghaffar Billoo, a social entrepreneur himself, who encouraged her to take on the cause of child abuse prevention to the next level. Since her early days Aisha has worked on neglect and malnutrition, and she continues this work at the Medical University where she is a Professor of Pediatrics.
Aisha has done considerable research and written on child sexual abuse, Internet pornography, commercial exploitation of children, in addition to numerous other articles and publications on child health care. Aisha has always remained an active citizen having been a leader in PPA, member of the editorial board of Pakistan Medical Association and Pakistan Medical Journalist Association, and is presently the member of the core committee on the National Action Plan against Child Abuse.