It was 19th of December, 2013. Thirteen-year-old Asma Bibi was playing in the very centre of her home with her sisters. Suddenly, the thundering sounds of shelling and indiscriminate firing started, engulfing the mud houses of Musakai village, which is located in the main town of the North Waziristan region, Mir Ali. Everyone scrambled in search of a safe place to wait out the fighting. Most of the males were out of the village for work and business. The once-peaceful village became a collection of wailing children and women, running in all directions. Women were picking up or dragging their beloved offspring, amidst the chaotic cacophony of explosions, crying and mourning.
Asma’s family also wanted to run outside and join the villagers in their escape.
Meanwhile a mortar shell crashed on to Asma’s home with an earth-shattering sound. It proved to be the doom of the innocent family. Precisely at the spot where Asma had been playing moments earlier, three people - her mother, brother and sister - lay dead in a pool of blood. The world changed for little Asma in that instant. She had lost what the local people call the “Place of Peace” [the mother’s lap] and the remaining three sisters lay wounded. Two of them were injured to a relatively minor extent, but the mortar fire cost Asma heavily - fragments from the explosion having pierced her spinal cord.
Staff at the Paraplegic Centre in Peshawar are highly critical of the state's attitude towards disabled Pakistanis
The mortar fire cost Asma heavily - fragments from the explosion having pierced her spinal cord
Untold numbers of reported and unreported women, of all ages, are victims of this conflict and are spending their lives in extreme pain and misery.
The 1998 census indicated that some 2.4 percent of people are disabled in Pakistan. This figure was hotly contested by civil society and NGOs working for the disabled, who pointed out the shortcomings of the survey methodology which, amongst other things, did not take into account the social barriers and stigma related to the disabled in the country.
Dr. Ilyas Syed, CEO at the Paraplegic Center Peshawar, is among those who question the veracity of these findings from 1998. “If we don’t know the precise extent of such a problem, how can we plan to address it?” he asks. He further adds that Pakistan has ratified the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) in 2011, which makes it mandatory for the Government to recognize and uphold the rights of Persons With Disabilities PWDs).
The reality on the ground is far from the commitments made by the government. And years of war in north-western Pakistan have only led to a mushrooming of people being disabled as they are wounded and maimed every other day in incidents of terrorism and the counter-terror conflict.
Asma would know.
“At that time I could not move my legs but I wasn’t aware that the thundering blast ruined my entire future”, she says on phone. “Besides this, my left hand also doesn’t work!” For her, it is a horrifying possibility that she would be at the mercy of others for the rest of her life.
This little unsung heroine and victim of war was a primary school student in her village school in the rough mountainous terrain. She has remained for almost seven months in different hospitals of the province for treatment. After the state forces launched an operation against jihadist terrorists in Waziristan, Asma’s family is now living in what is known as a ‘settled area’ of the Khyber-Pakhtunkhwa province. “I face two huge pains - one the loss of my dear ones and the other that I will be on a bed or a wheelchair for my entire life” she says through tears.
She is very clear who is at fault here:
“This is the utter failure of the state and state institutions; they are responsible for the safety and security of people and are accountable to the taxpayers and citizens. Since evacuation we couldn’t visit our place of birth, nor are we allowed to visit our mother’s grave.”
Asma is afraid that they won’t go back to her hometown in the future too. “I want to forget the horrible scene where in front of my eyes my family members were killed and the government and authorities treated us like dust! It is pathetic!” Asma exclaims.
Infrastructure and support for disabled people is generally weak in Pakistan - for the thousands of victims of conflict, it is dismal
Clinical psychologist Samera explains that female patients face much pressure from the in-laws wishing for a second wife
Samera Muzafar, a clinical psychologist, shares her experiences while caring for patients with damage to the the spinal cord – people in Asma’s position. “Those injured by bombs, gunfire and explosives mostly come to us in critical condition and in complete despair. They have psychological trauma, flashbacks and nightmares. To motivate them to live on and prevent despair and trauma from taking over their lives, we ask them to count the blessings that they do have. We say that you have eyes, ears etc. - you must utilise what you are left with and you can still become success stories!” Samera says.
But of course, this is not easy.
“We understand they have lost very important parts of their body but I find that mentally-strong persons can overcome their disability, while developing newer abilities,” she concludes.
The last census in Pakistan was held in 1998, after a gap of 16 years. And now, after a gap of 16 more years, it has still not been conducted although it is supposed to be held every ten years. “This is just another sign of the decay of national institutions which are of critical significance in a civilised society, but that have fallen on evil days in Pakistan due to political and bureaucratic lethargy”, Shahana Shah a retired federal secretary tells me. He runs an organisation for the rights of Persons with Disability (PWDs). She rejects the 2.4% figure for PWDs according to the last census.
“If in modern and developed countries the percentage is near 15%, then how in our country could the ratio be so low? This is a country where the polio virus is present and militancy is at its peak!” she exclaims.
Khushnuma was paralysed by a bullet striking her spinal cord as she returned from a wedding in Malakand district
Gul Meena belongs to the Federally Administered Tribal Area (FATA), bordering Afghanistan. This is the border area of Khyber Pakhtunkhwa and has witnessed a decade of conflict now. This war has paralysed and killed thousands of innocent people in the region. Gul Meena and many others are affected psychologically and physically by terror war. Gul is approaching her thirtieth birthday. She is shy and reserved in her attire and habits. A nurse is assisting her and teaching her exercise techniques. She takes every step with immense care.
“Some five years ago I was busy in my home in household chores when a stray mortar shell fell with a terrible sound. Something hit me on my left leg with extreme force and the severe pain made me unconscious.” Gul Meena recalled the story of her injury while following her instructor’s orders with one artificial leg at the Pakistan Institute of Prosthetic and Orthotic Sciences (PIPOS).
PIPOS was built in the basement of Khyber Teaching Hospital (KTH) during the 1980s Afghan war for rehabilitation of the Afghan refugees fleeing the conflict. Later the institute moved to its own building.
Since they are of immense value to the disabled, whether from war or otherwise, the Paraplegic Center and PIPOS are the two ‘positive’ buildings that came out as a result of extreme evil. Otherwise that war between ‘The Free World’ and ‘Communism’ has ruined the indigenous culture, peace and heritage of the region.
Samera Muzafar, the clinical psychologist, explains to me the mental state of disabled person, who has lost their normal life and become dependent on others for day-to-day activities. She says it angers them and that feelings of dependency make them suffer bouts of anxiety and depression. Often, these unfortunate men, women and children rely on denial.
Samera says that it is quite difficult for them to admit the future realities facing them - such persons, according to her, remain in the middle of pessimism and optimism and in this state they have to take on the attitudes of Pakistani society towards the disabled.
Amna, whose life was shattered by the same mortar shell that destroyed her home and killed her mother, must now find a way to survive despite her disability
She adds that disability is still a stigma in our society. A disabled human in our society is made to feel less valuable because they can’t contribute to society as they were once before. “Being a clinical psychologist, I tell them that without hands and feet still you can live with dignity, and through video clips of old successful graduates of Paraplegic Center I try to show them what is possible.”
Gul Meena recalls the horrible period of war:
“Those days were terrifying for our region. We have seen and heard the inexpressible stories of battle. These were events which made people mentally ill, amputated like me [she points towards her plastic leg] and killed dozens of people in the surroundings - and razed the infrastructure.”
She narrates how, after she was wounded by the stray mortar shell, her parents and uncles rushed her to a local hospital. “But I was unaware of what had happened to me due to my unconsciousness. After the first treatment at local hospital the doctors referred me to Islamabad immediately. My leg was amputated in the capital but no one could tell me the ugly news. I came to know by myself after some time in hospital - that I am no more a ‘normal’ person. I started crying along with my parents and other relatives at that moment.
Gul Meena still weeps about it.
After total silence for a moment, she cleans away her tears with her black shawl and recalls the time when she was energetic and mobile. “I was a common village girl and would go to the mountains with my sisters and cousins to cut grass for animals and collect firewood for the kitchen and oven, but for years now I can’t even get out of my home. I never thought that I would be a worthless body but ruthless humans made me this way. The Creator had given me a healthy and complete body…”
“All my friends have gotten married and they are living with their partners but my fate in this long, tough journey of life is written in such a way that I am to be alone!” she says.
The aftermath of a clash between Taliban and state forces - the impact on any civilians caught within these areas can be estimated from such images
The government is spending Rs 100 per disabled person every year. Without the administrative costs, it is spending Rs 30 per disabled person
Clinical psychologist Samera further tells me that female patients face much pressure from the in-laws, who demand a second wife. In most of cases it leads to severe depression.
Gul Meena told me that one trip to Peshawar for inspection at the PIPOS takes three days, and that her aged father is a poor farmer. “A trip to the provincial capital and a two-night stay in a hotel is very expensive for us. We come quarterly if my plastic made leg does not break.
I won’t call it a life, because I am dependent on people now. To whom can I complain?”
“I am waiting for Allah to avenge me from the unseen criminals!”.
She looks to the sky with hope and despair mingled.
“My mother and the rest of the family do care for me, but it is not possible for them to spare a person to look after me twenty-four hours a day, seven days a week. The fact is this: now I am a kind of burden on my poor family…” she concludes.
The young woman then confides: “
Sometimes I hear cursing from family members and in reaction I dare not show my emotions but at midnight when all are sleep, I weep alone about my day. Only the Creator sees and listens at that time.”
According to disability statistics from the World Health Organisation (WHO), more than 15% (around 1000 million) of the global population is faced with some kind of disability (functional impairment); which includes all the developed countries and advanced economies. It is also a fact, obviously, that the prevalence of disability increases with poverty, illiteracy and armed conflicts. But when it comes to Pakistan, this ratio drops down to a stunningly low 2.4%, as per the last census in 1998, mentioned earlier. One cannot help but wonder how much under-reporting, glossing over and negligence goes on, when such a low figure is stated.
“Authorities in charge of building regulations and departments for public transportation couldn’t seem to care less about the implementation of the building code, which includes accessibility for the disabled people. Neither the state nor the private sector have stepped up to systematically help disabled persons yet,” Rukhsana Shah tells me.
The war between terrorists and the state has meant that large numbers of civilians have been exposed to some of the most horrific injuries from various munitions
Khushnuma, a final year student of Islamic Studies, was coming back with her family from a wedding ceremony at Malakand eight months ago. Her car came under indiscriminate firing. As a result, her uncle and cousin were killed. She survived that bloodbath and is living with her family but a bullet pierced her back and damaged the spinal cord. Now she is moving around on a wheelchair her mother takes care of her all the time.
“The time bullet hit me and I felt that I had totally lost the lower parts of my body, but I did not expect such dependence, even for my most basic needs,” the young paralysed university student tells me – a narrative tragically similar to other young women in a similar situation.
“My relatives were telling me that for some time your feet would not work but later it will be OK. I told them that this is my spinal cord and I am well aware that it won’t recover for the rest of my life.”
According to the information from the Paraplegic Center, bomb blasts and related Incidents have damaged the spinal cords of 78 people in the recent past, who are now living as paralysed people under the care of the Centre. The Centre provide free treatment, food and lodging to the patients and one attendant. The Khyber-Pakhtunkhwa government, the Red Cross, ISWP, Doctors Without Borders and Helping Hands for Relief Development (HHRD) support the Paraplegic Center in Peshawar.
Khusnuma recalls:
“I would remain the center of attention at family functions and events - and there would be many responsibilities assigned to me. I would decorate homes and arrange for most of the lively activities for those particular days. But last week when I was at a cousin’s wedding in a wheelchair, I could not express in words how tough it is to sit and watch all my friends busy in activities - singing, dancing, and so on. And I was merely part of the audience. That hurt particularly bad!”
The government is spending Rs 100 per disabled person every year. Without the administrative costs, it is spending Rs 30 per disabled person. The main factors that result in disabilities are terrorist attacks, domestic violence and cousin marriages in the country, Rukhsana informs me. She further adds:
“The social contract between citizens and the state makes it imperative for the state to develop credible systems of data collection concerning the disabled to gauge their needs and take steps to rehabilitate them in society.”
As for Khushnuma, she says with a voice of steely determination:
“I promised myself and my parents that I will change this physical disability into ability and will achieve my goals despite all the difficulties. Personally I want to set an example for other people with special needs. Actually when I was under treatment for three consecutive months at the Paraplegic Centre, I observed that all of the disabled cried for hours but I did not. I chose to accept my disability as a challenge!” She smiles confidently.
“We do not want any particular perks or privileges from the state. We just want our basic rights as citizens!” she says.
Dr. Ilyas tells me that the Paraplegic Centre has treated and provided training to 8,000 patients with its 78 beds since its establishment. This was made possible through the cooperation of a complete team that includes a doctor, a nursing team, a physiotherapist, a clinical psychologist, an occupational therapist, an orthopedic specialist and a vocational trainer.
“Due to pain, I can’t sleep for the whole night. I don’t have any more desires in life”, teenage Asma tells me. “My heart breaks to watch people walking in the street, and I am unable to join them…” Asma’s voice trails off on the phone. Then I hear someone cursing:
“Allah di zaliman barbad ki”
“God ruin the ruthless”
Abdur Rauf Yousafzai may be reached at journalist.rauf@gmail.com. He tweets at @raufabdur
