Currently the Director of Aahung, Rahal Saeed has significant experience in program management, gender, empowerment, and reproductive health. She has worked for CEDPA (Centre for Population and Development Activities) in Washington, DC, where she was seconded to the Catalyst Consortium, a global reproductive health project.  She has an MA in International Training and Education with a focus on developing and implementing participatory training programs, non-formal education, gender, and international development.

Cami Hilsendager, IWHC: How did you become involved in the movement for women's and young people's health and rights?

Rahal Saeed: My mother was actually one of the founders of the women's movement in Pakistan, so I grew up with it. As I attended protests and events with her, I eventually became interested and started to read and research on my own. In terms of health, again, I think I was initially influenced by her, and eventually ended up looking at reproductive and sexual health from a rights perspective.

CH: Can you share a little about Aahung and your work there? What is it that makes your organization unique?

RS:  At Aahung we focus on sexual health and rights. What I like about Aahung and our work is that our perspective is holistic and integrated, so it's not just about health per se. There are too many organizations in reproductive health that focus on service delivery and the clinical side, but not on social determinants and more comprehensive approaches. For example, how can people's sexual health and the relationship between spouses (sexual and otherwise) improve if underlying gender power relations and social factors are not addressed?

What makes Aahung unique is that we are one of the very few organizations in Pakistan that address sexuality, sexual health and rights. And we work at different levels. We currently focus more on institutions, because we believe, given our relatively small size, that our strength lies in our ability to influence and empower large institutions to do two things: improve the services they provide to the community, and advocate for policy change.

For example, we work with schools-primarily in low-income areas, but we also work with some high-income schools. We train teachers on life skills education, and advocate for pedagogy that teaches assertiveness, confidence, decision-making, and independent thinking.  We also work to sensitize medical faculty to enable them to better address sexual health concerns, and we are advocating for greater inclusion of sexual health issues into allopathic and non-allopathic medical curricula.

Another element of our work is with community-based and non-profit organizations, primarily in one of the provinces of Pakistan called Sindh, helping them to incorporate sexual health issues into their work. We've started experimenting with theater, because some of our partners who we had trained said they had difficulty using our printed materials due to the low literacy levels. We did a workshop on theater for development and a whole campaign on street theater in two urban areas in Karachi, and are now beginning a similar campaign in Sindh.

CH: What kinds of challenges does it present being the only organization in Pakistan focusing on these issues?

RS: We end up being spread very thin because no one else is working on a lot of the issues that we are. Although more organizations focus on sexually transmitted diseases and HIV/AIDS, for example, we are one of the few organizations that approaches these issues from a rights-based perspective. Most of the others look at the clinical service delivery angle.

We're occasionally accused of being a little bit "in your face" because we openly say that we're working on sexual health and sexual rights. On the other hand, we present everything that we do in a way that is accepted and understood easily and perhaps that's why we're not as controversial as we could otherwise be.  We also find that there is a great demand for the information that we provide-people go through all kinds of things, physically and emotionally, and they often find it difficult to find healthcare providers who provide an adequate comfort level. In general, I believe most people are very receptive and open to communicating when their concerns are addressed in a supportive, non-judgmental manner.

CH: What are the major impacts of the overall political, social, and/or religious norms in Pakistan on the health and rights of women and young people?

RS: Pakistan has certain legislation that discriminates against women. Until very recently, there was no clear distinction between rape and adultery under the law. So, for example, if a married woman reported a rape, she was also often accused of committing adultery, because by reporting the rape she was admitting to sexual intercourse outside of marriage. Additionally, according to Pakistan's law, four male, pious, adult Muslim eyewitnesses were required to convict someone of rape. So if a woman was raped and knew the identity of the attacker, he could not be convicted unless she could produce these four witnesses who could testify that they had seen the crime take place.  Since this was rarely possible, again, rape survivors often just ended up being accused of adultery.

Feminists and other women's and human rights advocates have been demanding complete repeal of these laws, called the Hudood Ordinances. While this has not happened yet, much of this legislation is currently under review. I believe that a clear distinction has finally been made between rape and adultery, for example. However, given that the changes are so recent, we need to wait and see how effective they are and what the actual impact is on women's lives.

Customs like honor killings are rampant, and although they're not sanctioned by the state, the state tends to turn a blind eye to them. We also have a very patriarchal, machismo-type culture. There is a lot of suppression of women: many women are not allowed to work, usually by the male head(s) of the household, and are kept at home and/or out of school. Domestic violence is very common and, again, because of socio-cultural norms, it's not reported. Even the educated, wealthier people don't want to report things like domestic violence. And the state response to all this is inadequate.

Although Pakistan has made commitments to women's rights, within United Nations (UN) processes for example, there doesn't seem to be any real dedication to making them a reality. It seems like the government makes these commitments because they know they're supposed to. That deeper level of commitment to change seems to be missing-both at the level of government, and within the general population.

CH: Do you see the level of commitment to gender equality changing at all?

RS: I do see it changing-especially in urban settings. There are a lot more women working outside the home. Part of the change is driven by economics, but I think it's also partially driven by the fact that more girls have been educated over the past ten or 15 years. At every level, more families want to educate all their children-not just the sons, which is the way it used to be. And one of the inevitable outcomes of education is that you want to look for work. So as more and more women enter the labor force, they're changing a lot of the social norms. They're becoming economically independent, standing up for their rights, and maybe wanting to marry later, someone of their own choice. You see it much more in urban settings, but across the board norms do seem to be changing, even if very slowly.

CH: How does Aahung work to overcome the stigma and misinformation that surrounds sexuality and sex in Pakistan?

RS: We conduct a lot of trainings, and a core focus of those, as well as the many resources that we develop, is to sensitize participants on issues regarding sexuality and sexual health, stigma, discrimination, etc. We take every opportunity to get our messages across, and are often invited for talk shows and interviews on TV and the radio.

CH: Do you see much opposition to that work?

RS: Interestingly, what we often find when we go into communities are people who are desperate for information. Everyone's body changes, and there is no one to go to with questions in Pakistan. Masturbation is a classic example. There are so many myths surrounding issues like masturbation or nocturnal emissions for boys. They are believed to be against Islam, and to lead to all kinds of illnesses. But for little boys, nocturnal emissions are a normal part of growing up. Unfortunately, they can't discuss this with anyone. Much of the time we're very well received by groups and communities, because there is finally someone there to talk to them without judging them.

CH: What do you consider to be the role of civil society organizations like yours in achieving the broader goals that you have for your country?

RS: We play a role at multiple levels. Though we may not necessarily be doing service delivery directly, we still have to keep in touch with communities. The other role that we play is at the government level, to influence policy change-and that presents various challenges. For example, we're based in Karachi and all of the government is in Islamabad, which is a big struggle. It's hard for us to get the inroads because we're not living in Islamabad. All we can really do is keep advocating.

Civil society organizations in Pakistan need to strengthen their networks in general. What often ends up happening is that each organization will pick something up and go forward on its own, and often we duplicate efforts. We must develop and draw upon our collective strength.

We also need to reach out and learn from our partners in other parts of the world – there is a wealth of information out there in terms of expertise, best practices and lessons learned that we could get more benefit from.

CH: Is there a large civil society movement in Pakistan?

RS: It's growing. It's not big enough yet, but it's growing. There are definitely more organizations than there used to be. But, again, there is a disconnect between policymakers and civil society. There isn't enough dialogue. Actually, to give the government its due, it's really trying to improve. For instance, we recently consulted with the government on an initiative with UNAIDS to increase universal access to prevention, treatment, and care for people living with HIV/AIDS. The government wanted to get all civil society organizations together at the table to brainstorm and come up with ways to address these issues. So, the government is taking initiative, and of course, still needs to do a lot more. On the side of civil society, we need to continue to push for more meeting points.

CH: What do you think we can do-advocates, civil society organizations, etc.-to inspire and affect leadership on gender issues in the next generation?

RS: One way is by example. From the late 1970s to the late 1980s in Pakistan, when all of these laws against women were introduced, martial law was in place. That's when the women's movement was born. There was a lot of momentum and there was a lot to fight against. When martial law ended, while the laws remained, the situation wasn't as bad as it used to be, and somehow, along the way, some of the fervor has been lost. That's really sad, because when the women's movement was at its peak, it was this amazing time of emotion and power. People were fighting court cases and going out in the streets and demonstrating, and I feel like that life has now gone.

The generation that is maybe ten years younger than mine is still interested in the field of women's health and rights, but they view it more as a professional choice. In the non-profit, civil society sector, there has to be some amount of emotion involved. It's a cause; you have to really believe in what you're doing. And somehow I feel that we need to re-instill that vigor.

CH: What do you see as some of the greatest challenges to women's and young people's health and rights…in Pakistan or in the global context?

RS: The impact of HIV/AIDS on women's and young people's health and rights is huge, and there still isn't enough awareness about it-especially about feminization of the epidemic. Too many people, in government and in the general public, are not aware of the fact that the epidemic is now trickling into the general population. There is still time for prevention, but there needs to be greater focus on it, and soon. If that doesn't happen, women will obviously end up being greatly affected and impacted. There just needs to be more effort…there isn't enough being done on awareness-raising; there isn't enough being done on prevention programs or information regarding basic health care; there isn't enough provision of health services.

Governments need to take more responsibility in general. The way I see it, civil society organizations often end up doing what the government should be doing, but isn't. For example, governments in most developing countries really need to provide better services-any civil society organization's outreach is going to be minimal compared to what a government can do.

In Pakistan, for instance, the government has a whole network of rural health centers and basic health centers throughout the country, but they often lack doctors, other staff, and basic facilities. To be fair, many of the areas in question are remote, and given cultural norms, the people there want female doctors as obstetricians and gynecologists. But the female doctors won't go to these areas because they're not safe there, or there are no schools for their children. The government at least needs to create a climate that makes it easier for people to access certain services, or to provide better training to locally available healthcare providers. The government also needs to promote awareness and combat stigma and discrimination.

CH: What is your vision for an ideal or better world?

RS: An ideal world would be one where organizations like ours don't need to exist and where you don't need to have big conferences like the Fourth World Conference on Women in Beijing, or the International Conference on Population and Development, because all those issues are already addressed. Resources would already be invested into schools and health care centers; gender equality would no longer be an issue; people would be able to exercise their sexual rights and express their sexuality in a safe, healthy way and not be judged; and sexual abuse and gender-based violence would not exist or would at least be addressed swiftly and appropriately. Honestly, that would be an ideal world.

What I would also like to see happen is for people to engage in more advocacy for themselves, because I believe that's how change occurs. It's only when you decide, "I need this change, and I'm going to get people together, and I'm going to fight for it," that you see change happening. And globally, not just in Pakistan, women provide a great example. I really believe women are changing the world. You look at what's happening here in the U.S. with the November 2006 Congressional elections, and with Hillary Clinton running for President…you hear examples of women coming together in different regions and advocating against violence and for better HIV/AIDS policies…and when you hear these stories you realize that when women take things into their own hands, change begins to happen.