Yeh kis ka Kasur he?

Yeh kis ka Kasur he?
A 16-year-old Baloch girl once arrived at gynaecologist Dr Azra Ahsan’s clinic in Karachi complaining of abdominal pain. When she examined her, she found she was five months pregnant. “I asked her who did it,” Dr Azra said. “She said it was her stepfather.”
The girl’s mother who was sitting outside was brought into the room. Her response upon hearing the news was: “Ye ab meri bhi shaadi kharab karegi.” She will ruin my marriage.
By now we know that people who abuse children are known to them—they are not anonymous strangers but uncles, cousins, tuition teachers, qari sahebs, fathers, stepfathers, neighbours. We also know that not just girls but boys and transgendered children are abused.
Dr Azra Ahsan has found in the course of her clinical practice that often mothers are clueless that their child is being sexually abused. “Often teachers tell the mother and they come to me saying that the child has itchy and scratchy genitals and has discomfort urinating.” Other gynaecologists report that they have seen young girls with repeated urinary tract infections because they are being sexually abused. Abuse is rarely a one-time phenomenon. NGO Sahil compiled statistics to find that 97% of victims face it more than once.
In cases of incest, there is never any discussion as the topic is entirely socially unacceptable. Even if a child complains to the mother, the mother is unable to either believe them or take action. Lawyer Tahera Hasan, who works in family law, divorce and adoption cases, once dealt with a case of incest in which a 13-year-old girl was being abused by her father. “The mother left the house with the child but never told the man why,” she says. There was a discussion on taking legal action but Hasan said she was not in favour of it because it would make the child go to court and relive the trauma in public. This does not mean you are looking the other way, she stresses. It just means that there are lacunae or loopholes in the system that does not provide you security.
“You do not know if you will get justice. Child protection laws exist but the laws are not [in a sense] what matter at the end of the day. It is how society is structured and the repercussions.” We are the kind of society where divorced women are ostracised so you can imagine how much damage it would do a girl child if her case went public.

What to watch out for
Dr Sohail Thobani is a pediatrician in Karachi with three decades of clinical practice. He saw his first case 30 years ago in a family of foreigners. The woman brought in her six-year-old son who was constipated. Dr Thobani clearly felt the child was not behaving normally. “I kept asking questions because I felt something was just not right,” he recalls. During the conversation, the mother mentioned that the chowkidar was abusing the son. While Dr Thobani tried to get them the psychological help they needed, the family was in the process of leaving the country. “I can tell you nothing happened to that chowkidar,” he says.
Over the years, he has generally considered constipation a possible symptom of child abuse but he cautions that behavioural, rather than physical changes, are most important to be vigilant about. “Whenever I get a constipated child I ask who beats the child more,” he says, for example. This can be a reaction in children to physical abuse. “But sadly this is part of our culture.”
Being alert to emotional changes in your child is important. Once Dr Thobani saw a second case of sexual abuse in which an eight-year-old boy was brought in with fever. “I realised he had lots of other symptoms,” Dr Thobani recalls, non-specific ones like he did not want to go to school and was withdrawn etc. Upon the third visit, he discovered while talking to the mother who broke down, that it was the qari saheb who was the culprit. She had to leave the eight-year-old with the teacher while she went to drop her other child to tuitions. 
Dr Thobani and other doctors can often be the frontline defense in such cases. A man once brought him a child, which the doctor was convinced was not his own. “The gentleman brought an 11-year-old and there was every indication that this kid did not belong to him,” he says. “He was evasive. Had I been in any developed country in the world I would have called child protection services while they were sitting in my office.”
It is clear to him that the Kasur case is making us talk about the issues. “I diagnosed these cases,” he says. “But there may have been many more I missed. We are not empowering our children.”

The first most important thing to do is put distance between the child and the perpetrator, says lawyer Tahera Hasan, who works with the children of Machhar Colony and their families through Imkaan Welfare Organisation. She recalls a case she received in her legal practice in which a working woman had to leave her daughter with the aunt who was tormenting the child to the extent that the child had become dysfunctional. “She did not take the child out of the environment,” Hasan says. “You need to get distance between the perpetrator and the child so they don’t have to deal with it on a day-to-day basis.”
In the long run, children need to be comfortable enough to talk to you. In Machhar Colony, young girls are registered to come play at their recreational space called ‘Khel’. Tahera Hasan recently called in their mothers from the community to talk to them about the fact that their 10- to 15-year-old daughters were going out in the street and needed to be educated about molestation and their personal safety. “This is a conservative community,” she says. “I told them that if they did not talk to their daughters they would not find out if they were molested. There will be rapes and they will not find out.” After an open conversation many mothers said they would speak to their children. But some mothers admitted that they would find it difficult. Tahera Hasan then said, that if they permitted it, she would be happy to educate their children if they found the subject too difficult to broach. They mothers said absolutely.
The numbers are epidemically high: one in five children in Pakistan are sexually abused. That means you probably know someone who has been abused as a child or have been yourself. The late Masud Alam, a journalism trainer who conducted workshops, used to do an exercise with his groups. Everyone would write ‘yes’ or ‘no’ on a chit of paper to answer the question whether they had been sexually abused. The anonymous chits would be gathered in a box and then they would count the number of people who had been abused. It was always startlingly high.
When I ran a daily crime map on page 18 of The Express Tribune newspaper in Karachi, I would often berate my male crime reporter Faraz Khan that we never seemed to get any rape statistics. “Are you telling me there hasn’t been a single rape in Karachi today,” I would ask him in frustration. Perhaps my question was unfair given how the system worked. He said these cases never made it to the roznamcha or police blotter. And I knew that was the case because we simply did not support the confidential reporting of rape, child abuse and molestation cases. And as long as we don’t talk about it and tell our children about it, Kasur will keep happening.