On July 23, 2022, Dr Naila Bashir, Incharge HIV Center at Pakistan Institute of Medical Sciences in Islamabad, Pakistan, tweeted that “74 new HIV patients (men, women, children, transgender) have been registered in June 2022…Total 4301 pts are registered since 2005.”
In June 2021, The NYT Magazine, Al-Jazeera and CDC reported that more than 1,500 people, mostly children, tested positive for HIV, according to the Provincial Health Ministry. Most of these patients had not even heard of HIV before.
In April 2020, CDC reported that 1,353 people, approximately 75 percent of whom are younger than 15 years, tested positive for HIV in Ratodero, a subdistrict of Larkana in Sindh, Pakistan.
In July 2019, a mass outbreak of HIV among children and babies in small villages around Ratodero, Sindh was reported. National Library of Medicine and NPR reported that 930 people, among the 31,239 tested, were positive for HIV. Some 763 of these patients were younger than 16 years of age.
In August 2017, multiple Pakistani newspapers reported that 45 people, among the 4,500 randomly selected samples, tested positive for HIV in Bhattiwala, a small village near Chiniot district in Punjab, Pakistan. The incharge of the local government hospital denied the prevalence of HIV in Bhattiwala altogether.
That cautionary tale about HIV turned out to be the last story in Phool by Akhtar Abbas. He was removed from his editorship. Even prior to that, he had received criticism for publishing inappropriate content for children.
Between 1990 and 2010, I was a child in a small village near Chiniot. We had a monthly subscription to one of the most popular children’s magazines in Pakistan, Phool. One corner of the magazine cover always read: “for children between ages 08 to 18.” The last story in Phool, called the “bedtime story,” was written by its then editor, Akhtar Abbas. As children in a small village, newspapers and children’s magazines were our only window to the bigger world. We didn’t learn about these issues in the local government school that we attended. We didn’t watch TV. My siblings and I loved Phool because its content made us feel like we were part of mature, adult conversations despite reading a children’s magazine and despite being children.
In 2010s, I was in my mid-teens when a monthly issue of Phool arrived. I grabbed the magazine and ran upstairs, where I devoured the magazine, hiding from my siblings. The bedtime story in that issue was about HIV. I only remember vague details now where a male child, in his teen years, steals money from his parents and ends up visiting a sex-worker, which leads to his HIV infection. The story was a masterpiece for a children’s magazines. It never explicitly mentioned sex. Only children old enough to know about these issues would understand it, younger children would have needed someone to explain it to them.
That cautionary tale about HIV turned out to be the last story in Phool by Akhtar Abbas. He was removed from his editorship. Even prior to that, he had received criticism for publishing inappropriate content for children. As children, we loved that content because it cautioned us about the challenges of being children in a country where sexual violence is rampant. Our families and our community members were uneducated about many of these issues and had little exposure to the world outside of our villages or nearby cities. Phool taught us how to navigate our lives as kids more than any adult around us did. When the next issue of Phool arrived, it was a complete contrast to the previous issues. We felt it was for kids aged between 04-08. We stopped reading the magazine.
Reading about the spread of HIV among children in Pakistan always reminds me of that bedtime story about HIV in Phool. When I was a child, Pakistan always chose quiet over conversation anytime it came to sensitive issues, especially sex. I am in my early 30s now, but nothing has changed about this evasive behaviour.
Many of the HIV positive patients in Chiniot reported that their friends and family have started questioning their character after they tested positive, despite the fact that most of these cases were reportedly transmitted via reuse of injections and shaving blades. Some of these infections did spread via consensual and nonconsensual sexual intercourse, especially in the case of vulnerable populations like young children. The denial of the incharge of Chiniot’s local hospital highlights this paradox: most people refuse to engage in any serious conversation that invokes sex in the slightest, but they are also unable to think beyond sex in any conversation that has sex as a part of it.
It is impossible to sensitise people or create awareness about HIV or monkeypox until Pakistan is willing to talk about sex and sexual health. It is everyone’s responsibility to create a nonjudgmental and safe space for these conversations so the laypersons in small, distant villages know that it is more important to talk about HIV than trying to prove that they did not engage in sex or illicit sex.
HIV numbers cited above are likely underreported because the majority of Pakistan’s most vulnerable people know little about HIV or don’t have access to monetary or medical resources to get tested. When they test positive, many are likely to hide it because of the stigmatisation of HIV.
It is impossible to sensitise people or create awareness about HIV or monkeypox until Pakistan is willing to talk about sex and sexual health. It is everyone’s responsibility to create a nonjudgmental and safe space for these conversations so the laypersons in small, distant villages know that it is more important to talk about HIV than trying to prove that they did not engage in sex or illicit sex.
Removing Akhtar Abbas from editing a children’s magazine because he wrote about HIV has only hurt the children – especially from non-urban and non-English speaking communities, who used to read Phool as kids, who are now adults, and who have no magazine like Phool that can teach their children about staying safe in a society where cases of HIV and sexual violence against children are on the rise.
