When I arrived in Karachi, I was shocked to see men holding hands. I think you know what my initial thought was. However, little did I realize that men hold hands here all the time! It is a symbol of their brotherhood and friendship. Relationships amongst friends is so strong here that people are not afraid to show their affection in public. In the west (taking Canada as an example), when two friends of the same sex express their friendship in public by holding hands, individuals automatically assume the presence of homosexual relationship, just as I did.
We put labels on everything but do not even know why or where these labels originate from. We fail to understand the big picture and instead take the easy way out because society dictates what is normal and what is not. Apparently, society says it is "not normal" for individuals of the same sex to hold hands without an underlying meaning behind it. But what does "normal" really mean and who has the right to define it? My idea of what "normal" means is completely different than yours.

Additionally, I feel that most of the time (East, West, South and North) we are too engrossed in our own lives that we fail to truly love those around us. Our family, friends and even strangers. We rush about trying to fulfill our daily tasks that we forget to express our love and affection to those that matter us the most. We spend hours at work on our desks and with our computers yet our families and friends don't even get one hour with us. To tell you the truth, I am just as guilty of this as the next person.

How can an individual spend time with their family and friends when societal pressures are massive and demanding? Are these pressures man made? Do we really not have time for our loved ones anymore?

Maslow's Hierarchy of needs is depicted as a pyramid consisting of five levels. The lowest level is asssociated with physiological needs (health, food, and sleep), then safety, belonging, Esteem and finally the uppermost level is associated with achieving self-actualization. Why am I telling you something you already know??

Poverty remains to be a problem in most developing countries, including Pakistan, which has resulted in an exceptional slow progress towards development. Without going into the details, poverty also affects a person's physical, professional and psychological advancement.

Many people are so poor that they cannot even meet their very basic physiological needs. They are unable to fill their stomachs, provide a shelter for their families and are at a risk for several diseases. Hence, a person becomes more engrossed in meeting their lower needs that they eventually abandon their higher needs. This makes it difficult for them to advance higher and to recognize their potential, but not impossible.

The situation is further complicated when a country is unable to meet the security needs (physiological and psychosocial in nature) of its people. Not only does there remain an overwhelming sense of food insecurity but one also becomes constantly afraid for their lives. Such is the case in Pakistan. The political and social situation is so volatile that individuals are constrained and suppressed.

Unfortunately, poverty and insecurity can sometimes lead to abandonment of morals and ethics. I am not trying to make excuses but only offering a different perspective. The poverty rate in Pakistan has a positive co-relationship with the crime rate, as with most developing countries. In Karachi alone, 200 mobile phones are stolen each day. When your basic needs for survival are not met one is forced to do whatever it takes to meet those needs, especially when your family depends on you. Now when I look at photos of individuals being caught of theft I feel sad for some reason but my rational mind also starts to kick in. Initially, I used to look at these photos and say, "Good! They deserve to be caught!" Now I look at the same pictures and wonder what might have motivated or influenced them to take such actions. I was always aware that no action or thought is influenced by one single factor, but instead multiple factors. However, I am now living this principle...

I can honestly say now that while being in Canada, I had taken a lot of things for granted. Its the little things that mean so much. Its these little things that now carry a lot of weight for me.

Light. Electricity. Gas. Imagine your life without it. Five months ago I would not be able to imagine it either, until now. We rely so much on electric power that it affects every aspect of our life.

For more than 20 hours, all of Karachi has been out of power. It started off with slight interruptions through out the evening but then the lights went off permanently. Even the generator at the women's hostel in AKU stopped working for awhile. Because I was extremely hungry and there was no gas to cook, a friend and I went out to eat. Roads and streets were dark. People everywhere. So many cars on the road. Friends and strangers sitting in parks, conversing with each other. Families and friends sitting outside having chai (tea). Boys playing cricket outside with their street friends.

On the downside, many people hardly slept because it was too hot. Some slept on the rooftops of their apartment buildings. Those who could not afford to eat out at restaurants, slept hungry. Little kids afraid of the dark, held on to their mothers all night. Unable to work on assignments and upcoming deadlines. Unable to bathe. Unable to cook. Unable to touch. Unable to SEE.

Sadly, this situation is not new for the people of Pakistan. In fact, it is a regular occurrence. Sure some households have generators and other backup powers source, but not everyone is that fortunate. Pakistanis plan their days accordingly because they know that the power will go at anytime. Food is cooked as early as possible. Clothes for the next day are ironed out. But when I asked them, "Doesn't it bother you when the power goes off daily?" They answer, "Yes it does but we are used to it now." These individuals try to do with what they have but people like me are dying with out power. No AC to cool me down. No Internet to surf the net. Luxuries for many.

Something sad happened when the power went out last night. A baby from a government hospital was kidnapped. I do not know who was part of this horrific and sadistic act, but I would not be surprised if you told me that the doctors and nurses played a part. Only God knows where this child is right now. Only God knows what is in store for her/him. I can give you some ideas, but that should be left for another blog.

In my opinion, Pakistan has an abundant amount of natural resources and manpower if utilized adequately and ethically. Too bad the wealth this country has to offer is not actualized.

I am becoming more and more frustrated with the Government of Pakistan. These feelings have been there since the day I got here but it has now been intensified as I am taking classes in PHC and HSM.

I have already mentioned the inadequate provision of health care services for the people of Pakistan as well as decreased health expenditure based on GDP in my earlier blog. Second, is the issue of a decreased will to act and implement on behalf of the government and its ministries. Pakistan has beautiful health policies, probably the best in the developing world. However, these policies are only beautiful on paper. Pakistan lacks the will to properly implement these policies so as to achieve maximum health outcomes. I am having a hard time understanding whether this is about lack of will or lack of human and material resources. Let me give you an example. Pakistan's Polio Policy is top notch but there is an absence of proper monitoring and evaluation surveillance systems. Each year polio vaccinations, polio drops and Vitamin A capsules are dispersed to health care clinics based on rough estimates. Numbers from the previous year are simply rolled over to the next year. There is no up-to-date data available in order to analyze trends or patterns. There is a system in place, but it is not followed due to reasons X, Y, and Z. How is a program that is needed in a country with the highest polio prevalence rate supposed to survive and sustain when there is mismanagement and lack of accountability?

Second example, a country wide food program was implemented in Pakistan by AKU and other NGOs a few years back for primary and secondary school-aged girls. Based on the squatter settlements randomized, close to 4,000 schools were identified by the government. Upon initial assessment and field visits, some schools were only written on paper but did not actually exist. The government had claimed such schools when funds were being allocated to each school. If these schools did not exist, where were the funds going? I am sure you can figure this one out.

There is no sense of ownership and accountability. Money is pocketed by the elite and the powerful at the expense of citizens. These citizens are well aware of the corruption but their words are, "We have been dealing with this for as long as we can remember." When questioned as to why nothing is being done about it, they reply, "What can we do. This is how it is." This reminds me of a statement made by His Highness the Aga Khan at the Seerat Conference in Pakistan, " The anchors of moral behaviour appear to have dragged to such depths that they no longer hold firm the ship of life. What was once wrong is now simply unconventional, and for the sake of individual freedom must be tolerated. What is tolerated soon becomes accepted. Contrarily, what was once right is now viewed as outdated, old-fashioned and is often the target of ridicule." (1976) I fear that we have reached this state. Many Pakistanis have lost faith in their countrymen and their government, yet they chose to do nothing about it.
As for me, I will try to remain hopeful....

What is the purpose of education?

Is it to memorize? Is it to regurgitate what you have memorized? Is it used for the purpose of application so we can continue with our existence? Sadly, this is exactly the case in most institutions of learning. Some would call this 'intellectual ignorance.'

According to Paolo Freire, education serves two purposes. It either domesticates or liberates.

Domestication simply means to take something away from its natural environment and place it in a controlling environment. Another word to use for domestication is 'taming.' Through this, there is a degree of control. Conversely, liberty is a condition which allows individuals to act according to their own will.

Therefore, the purpose of education is not to domesticate but to liberate. Domestication of education confines an individual to one realm of thinking. There is no room for creativity, neither is there encouragement for critical thinking. Through coercion we learn to accept someone else's point of view, instead of exploring our own. We become engrossed with memorization and regurgitation.

So if the purpose of education is to liberate, then liberate from what and from whom?
In ancient Greece, Socrates argued that education was about drawing out what was already within the student. Education comes from the Latin meaning "to lead out." Hence, education plays a key role in self-awareness and self-reflection. It allows one to become aware of one's own abilities, goals, aspirations, and even gaps. In a way, one becomes aware of his/her own oppression and seeks out avenues to eradicate this oppression. We liberate ourselves.

I can go on and on with this topic but I will stop here, for now. I am writing about this because I was recently inspired by a wonderful professor at the Aga Khan University, Karachi. Her style of teaching was similar to how I was taught at my University, which was quite liberating. During my university years we were given the freedom to explore various domains of learning whilst covering the major aspects of nursing. I never really appreciated this style of learning until I started to apply these principles regularly after graduation, both professionally and personally. It brings me great pleasure and pride to see AKU implementing the principles of 'popular education.' The educators at AKU are interested primarily in each student's intellectual journey by supporting their growth. Grades are not seen as ends. I am honored to be a recipient of this form of liberation, once again.

A couple nights ago, I woke up from my sleep in distress because of a dream. I was distraught and overcome with immense sadness and feelings of hopelessness. I think I must have cried for almost half an hour. I know dreams are just that, dreams, and usually they are meaningless. However, I would say this was an exception. Let me share with you what this dream was about.

We were driving around Karachi when I noticed a dead body lying on the road. Worse, the head was cut off and lying next to the body. Next to this dead body was a man asking for help from everyone and anyone. He needed help to find a proper burial spot for the man. Unfortunately, this man had no legs (common across Pakistan either due to polio or other circumstances) and hence was not able to seek further assistance. What got me was the fact that people were walking and driving by but no one was willing to provide any help. They were too engrossed in their own worlds to care. The dead man had no family or friends around him. The other man was begging for help but no one could hear his voice.

That night I was too sad to reflect on the dream, and so I cried myself to sleep. The next morning I tried to gain some insight, especially because I could not erase the picture out of my mind. The picture is till clear in my mind. Through the help of friends and soul-searching, the following are a few of my reflections. There are just too many to include here.

1) I took this dream to be a message, a sign to act. I feel that too often we are concerned with treating the symptom of poverty but hardly do we try to understand the root problem. By no means am I saying that we should not help those who need our help because a little bit definitely goes a long way. If we want to eradicate poverty, then we must explore issues perpetuating this. This is not simple, in fact, it is quite complicated. After this dream, I am feeling that I have to, no, I need to do something. I have always felt this way (hence the reason for going into nursing and coming to karachi) but these feelings have now intensified. Rest assured that these feelings are not based on pity, but rather on feelings of responsibility and simply because...I want to....

2) I know I need to re-channel my energy from feelings of hopelessness to that of hopefulness. It is our responsibility to re-kindle the spark of hope for those who need it and who have lost all hope. I say re-kindle because we are all born with this spark but sometimes we need support and encouragement from others. I too need to be hopeful because this will guide my attitude towards others and what actions I will need to take to help others.