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According to psychiatric research, 800,000 people in Kashmir – including women – are affected by PTSD. -File photo by AFP

SRINAGAR: It is like any other day at the valley’s leading gynecologist’s clinic: Crowded and packed with impulsive patients, who have come from different part of Kashmir to the summer capital, Srinagar.

For 17-year-old Maleeha, however, the day has brought anxiousness and worry. On her first visit to the doctor, Maleeha has been diagnosed of severe Polycystic Ovarian Syndrome (PCOS) which she fears will  make her infertile.

“I am extremely worried about this problem as it is known to cause infertility,” says Maleeha, who belongs to Baramullah.

Another patient, Andleeb, who has been married for six years, has been visiting the doctor for two years. She suffers from infertility, the cause for which remains unknown.

“I have got every test done but the doctors have not been able to find the reason for my inability to bear children. It has ruined my life,” she says.

Thousands of women in Kashmir are increasingly suffering from infertility. Couples are finding  hard to fight the problem which has saddened hundreds of families across the valley.

Leading gynecologist Dr Farhat Hameed says infertility is affecting the younger age group at an alarming rate.

She cites late marriages, hormonal imbalance, unhealthy lifestyles and stress as major reasons for infertility-related problems.

“The marital age for Kashmiri women has risen from 18-21 to 27-35 years. Girls prefer quality education and a good career before marriage. This has affected their child-bearing capacity,” Dr Farhat insists.

Studies at the premier Sher-e-Kashmir Institute of Medical Science (SKIMS) indicate 15.7 per cent women at childbearing age will never have an offspring without clinical intervention. A further 14 per cent of women are unable to conceive because of unknown medical conditions.

Dr Farhat added that conflict also gave way to infertility problems for women in the disputed region, due to increased stress levels.

“Conflict has resulted in many psychiatric  problems in women, including depression, Post Traumatic Stress Disorder (PTSD) and anxiety, which directly affect child birth.”

According to psychiatric research, 800,000 people in Kashmir – including women – are affected by PTSD.

The problem, once unknown in Kashmir, now affects 10 per cent of its female population, including teenagers and young women.

Gynecologist Dr Sameena says that PCOS is one of the most common disease affecting young women of Kashmir.

“The number of patients diagnosed with PCOS is adding with each day.”

PCOS is a major endocrine disorder which affects women of reproductive age. It is one of the leading causes of infertility across the world.

A SKIMS study of 112 young and adolescent PCOS women found that 65 to 70 per cent of them suffered from psychiatric illnesses, eight patients suffered from obsessive compulsive disorder (OCD), five had PTSD, and 27 were depressed.

Over the years, In- Vitro Fertilization (IVF) clinics have raised some hopes for childless women. Kashmir had none until 2003.

IVF procedures, however, are expensive. They cost between Rs.200,000 to 300,000, making them out of reach for majority of the population.

“My husband is a clerk  and does not earn much,” says Afsana. “We cannot afford IVF or similar treatments. I am reconciled to not having a child.”

Dr Farhat who runs an IVF clinic admits to the high costs but says “we do provide some concession to poor patients.”

Making things worse for the women are the social ramifications of infertility. Childless women are stigmatised and are looked down upon. Married women face the wrath of in-laws and husbands while unwedded girls fear marriage.

Such fear forces Tasleema Begum to take her 23-year-old daughter, Amber, to another district for infertility treatment to avoid being seen by her family.

“I do not want people to know Amber suffers from PCOS,” says her mother.  “Such things are not socially acceptable.”

Thirty-five-year-old Saima who is childless after four years of marriage is regularly abused. “Not a day passes when I don’t face abuse from my husband and in-laws for not bearing children,” she says.

“For me, the torture is two-fold.” The misbehaviour of in-laws hurts her more than childlessness.

“I am trying the best medication and doctors but the rest is in God’s hands,” she says. “Why should women be blamed for it?”

Many women are divorced over their inability to bear children, a trend common in rural areas.

The story about the health of women in Kashmir does not end here. Besides the sick reproductive health, the general health of Kashmir women is fasting deteriorating. Hypertension and orthopedic problems have become common.

According to Dr M.A.Kamili, a leading physician, one of every 10 women above the age of 40 years  are hypertensive . Fifty percent of women above the age-group of 60 years are hypertensive. However, the ratio of female hypertensive patients below 40 years of age is 15-20 percent.

Besides age, obesity, excessive intake of salt and unhealthy lifestyles have given rise to hypertension to women in the valley.

“Though the salt requirement of our body is six grams, which is fulfilled by any food we take be it fruit or vegetables, an average Kashmiri takes 20-22 grams of salt. This has resulted in rising ratio of hypertension here,” notes Dr Kamli.

Amongst the orthopedic problem, knee aches and lower back pain are common amongst women, besides osteoporosis. Osteoporosis is a disease of bone that leads to an increased risk of fracture. In osteoporosis the bone mineral density (BMD) is reduced, the microarchitecture of the bones is disrupted, and the amount and variety of proteins in bone are altered.

This is attributed to lack of required intake of calcium during and post pregnancy, during lactation period and after menopause. Adding to the causes  is overwork, lifting of heavy objects and lack of appropriate exercise.

“Knee ache, back ache and lack of calcium, which lead to osteoporosis” states Dr Manzoor Ahmad Halwai, a local orthopaedician. According to him, 40 percent of women in Kashmir suffer from calcium deficiency. The problem is more urban than rural because of the sedentary lifestyle in urban cities.

Gynecologist, Dr Afroza Jan reveals that a lack of awareness amongst the women of Kashmir regarding the calcium requirement of their body at various stages has resulted in orthopedic problems.

“Calcium gained from food does not suffice a woman’s requirements. This is because of her biological pressure during pregnancy and lactation period.”

She adds that during pregnancy, a lot of calcium is needed for the health of the child and mother. It is the same during the lactation period.

“But women here do not take calcium supplements at these crucial stages, the result is severe calcium deficiency giving way to orthopedic problems, commonly osteoporosis,” reveals Dr Afroza.

Comments (42) Closed

Cyrus Howell Dec 17, 2012 05:12pm
Overpopulation simply means future wars over scarce resources. Man is the most successful species on the planet. Now We are too successful and are staring The Law of Diminishing Returns square in the face.
Vinu Dec 17, 2012 03:35am
Yes, This is why a country called Pakistan has more drug addicted people on planet then anywhere else. Please read UN reports on drug use and terrorism. Every pakistani politician and full military involved in this business.
Reality Check Please? Dec 16, 2012 01:40pm
War and Occupation has horrendous impact on people! This is just one of the examples!
Gautham Dec 17, 2012 10:35pm
Uzma, I'm not sure which article in TOI you are referring to. I agree the comments on TOI are more acerbic and sometimes outright disgusting. Another way to look at that is that TOI does less 'editing' than Dawn. While I'm no one to apologize for your exasperation about TOI, I respect your observations. We are entitled to our opinions, however biased and prejudiced they are. We cant change the reality and the reality is - Kashmir is going thorough a trauma and yes some of them want to be separated and that ain't gonna happen in my life time. The fact is, how much ever disbelief it may cause to opinionated people like you, things have gotten better over there. The very fact that we are reading news on social parameters like health & education, and not bomb blasts, is a proof of that change.
Rani Sharma Dec 17, 2012 11:16am
How true!! How could I have not posted this?
Uzma Dec 17, 2012 04:20am
Wish Indian newspapers also allowed non-Indian commentators to make remarks. When I read Times of India and the comments in it, especially on Kashmir-related stories, all I see is calls for genocide and eviction of Kashmiris from Kashmir. In the end it doesn't matter what Indians think about Kashmir, as long as Kashmiris don't want to be part of India, flailing about and commenting on blogs won't help.
Gautham Dec 17, 2012 10:51pm
Sana, so you are the Kashmir 'specialist' in Dawn. I just clicked on your name and I got half a dozen articles - all on Kashmir! I read all of them earlier and do remember two things distinctly. 1. All highlight problems Kashmiris are facing or have faced in the past. In most of your stories, you have basically taken a universal problem and applied to Kashmir selectively. 2. In all the stories, the scope of problem definition is specific to India's J&K. None included the other side of the Kashmir. I'm not sure if you have an agenda or if you are catering to certain audience, please do remember that this paper is read by most knowledgeable Indians too, who get stories from multiple sources in the international media and can cross verify the facts against opinions. I'm not sure if Dawn will publish this comment but I request you to include larger section of demographies in the scope of the problem definition. That way, it looks more universal.
Uzma Dec 17, 2012 04:21am
'Happy'! Did you read the piece?
Hoon (India) Dec 17, 2012 10:27am
Totally agree with you Gautham, followed that story on IT jobs in Kasmir too, very biased !
Rani Sharma Dec 17, 2012 11:12am
The purpose of this article is to establish that Kashmir is not part of India but separate. Stress infertility etc affect people of the female gender all over the world. Note the author did not use the word India even once. very clever.
Sue Sturgess Dec 18, 2012 12:48am
nature will find its own balance in an overpopulated world
Sue Sturgess Dec 18, 2012 12:51am
How do these newspapers know the nationality of those making comments? Unless you tell them, or choose a nick that makes it obvious, they have no way of knowing.
raika45 Dec 17, 2012 03:00pm
What is it with Dawn to come up with topics showing the despair of Kashmiris ?And that too subjects that get shot down by your readers.I and my wife had to wait for 6 years before we got our what doctors call the " precious'child. And that through medical help. We have no stress or other problems. It was a fact of nature.You cannot blame the system or the conditions .Come on Dawn, you can do better.By the way,My son is doing really well in life.
Gautham Dec 18, 2012 06:47pm
Naeem, that's alright. Stay where you like and be a citizen of the country you like. But I guess you need to take care of your womenfolk and give them 'freedom' from the problems described above. Just saying 'we don't want to be part of India' will not give the women better health to job opportunities. By now, you would have guessed what minimum you must do to distress the Kashmiri society. If you still have not figured out, there is no hope for Kashmiri society for a long time to come.
DK Dec 18, 2012 02:39am
.....problem is inbreeding. Kashmiri women should branch out and seek partners from other communities....
Neer Nayan Dec 17, 2012 05:49pm
Let us refrain from indulging in a blame-game, and ponder over this global issue! This problem is taking its toll all over the globe, but the females in the extremely conservative sub-continent are the most affected ones, physically, emotionally as well as socially. Sadly, there is hardly any ray of hope around. "Ibn e Mariyam Hua Kare Koi.. In Dardon Ki Dawa Kare Koi..."
Rajesh Dec 18, 2012 03:32am
How come we never hear what is happening in Azad Kashmir? Is this biased reporting in Pakistani media?
Sandip Dec 17, 2012 12:58pm
Not sure why women are represented as there only job is to create babies? They need to have there carrier there world. We have 6 Billion of us not sure if we need more.
syed hussain Dec 17, 2012 07:34pm
Fertility decline is so evident all over india with spawning fertility clinics. Women in india seem to suffer from pcod, endometriosis, hyper/hypothyroidism a lot more and a more thorough research needs to be done to find the root cause. Added to this female infanticide is not helping. May be this is natures way to control over population.
AM Dec 17, 2012 05:53pm
It's sad really. Worst of all, the "world's largest democracy" will never look at it as their own problem. But to their defence, they are too buys dealing with selective abortions there.
rani raina Dec 18, 2012 04:53pm
Naeem, if you are not Indian, leave India that is provided any other country is willing to provide you sanctuary.
george Dec 17, 2012 10:05pm
There are 1.2 billion muslims in the world. Muslims have the highest birthrate in UK. This is same everywhere. Muslims believe they will rule the world by their numbers even though they hardly have any brains.
Neer Nayan Dec 17, 2012 05:40pm
Insensitive comment! Kindly behave.
aks_USA Dec 18, 2012 06:58pm
Well we have captured u and will not leave u--do whatever u can do
Isadora Dec 17, 2012 07:07pm
Unbelievable that husbands and in-laws would treat a family member so badly simply because the woman doesn't conceive. She is still a human being with feelings that should be respected. However, if she is surrounded by ignorance, she is not likely to find much of that respect.
Ataullah Dec 18, 2012 04:07pm
Generally women are blamed as part of local culture, customs, illiteracy & lack of education. Specially Ilim/knowledge of Deen e Islam & believe in Allah' Will to give or not to give, it is His Will, whether to give children or wealth, all to test one's believe, trust with Sabr & Shukr.
Jai Dec 18, 2012 03:56pm
Mr. Naeem .please feel free to make any travel plans that suits you. Per your convinience and no hurry at all. India is already over polulated and we dont mind a few people leaving.
Ataullah Dec 18, 2012 03:41pm
It could be for many reasons not particularly with this region or this part of the world only. due Wars, Stress, Lack of Sleep, Variety of Food Availability, Intake of Good & Variety of Food by Population, Availability of Fertile Land & Clean Drinking Water, Land & Water, Poluted & or Poisened by India Government, so & so, on....
Rahul Dec 18, 2012 12:09pm
Did the reporter check any other city in India?
Gautham Dec 16, 2012 02:39pm
I don't mean to water down the problem Kashmiri women are facing, but infertility has gone up worldwide. Remember the story on the sperm count of French men, which fell by a third (33%), that is alarming too. The infertility of women due to stress is growing alarming in the rest of India too. What makes Kasmiri women's live miserable is continuing violence and the resulting PTSD. Just like a story on job opportunities in IT in Kashmir, that was published in Dawn a couple of weeks back, the situation is not any more pitiable than rest of India. Thank God there are blogs and people like me can respond, otherwise this article would look very propagandistic, perhaps to 'naive' people like me who think the author is focused on one selective demography while it is actually universal. Cessation of hostilities is important for well being and prosperity.
ashu Dec 16, 2012 02:24pm
so it is good to know that women in Kashmir want quality education and they are happy there
Ignorantme Dec 17, 2012 04:50pm
This is a global phenomenon not just a issue for Kashmiris. But it should not be a problem because islam is growing well at alarming rate despite muslims being caught in cross fires throughout the world! Isn't that what we all wanted (particularly the writer)? Just produce more children (even if you cant take care of them very well) and in the next 50 years half of the world population will be muslims! In next 100 years everyone in the world will be a muslim! The world will be much more peaceful at that time.
F Hyat Dec 17, 2012 12:49am
The reason for infertility is not just one sided, the husbands should also be tested for infertility along with the wives.
Naeem Dec 17, 2012 02:34pm
Because we kashmiris are not Indians and dont want to be indians.
andy (ON, Canada) Dec 16, 2012 03:20pm
the heading is deceiving. It would be great if you compare the infertility rates with rest of india. I am sure it is not too different. stress is everywhere. the most direct relationship is with late age of child bearing. this is happening in all developing and developed countries. Not only PCOD rates are increasing, the way we diagnose it has significantly improved in last decade or so.
PK Dec 17, 2012 11:48am
Pakistan is fighting the war on terror since more than a decade . Facing bomb blast & other forms of violence almost daily . The situation is much worse in Pakistan as compared to Kshmir .What is the intention of the author in heighlighting the peanut size problem when she & her country is facing problems of teh size of montains.
kiran Dec 17, 2012 11:57am
Mahek u said. It is globel problem, lifestyle, food, polution, stress etc r causing this.
Mahek Dec 16, 2012 07:26pm
Sana,what`s the motive behind representing the global problems as only Kasmir`s Problem..the whole world is suffering form stress,infertility...
Muhammad Dec 17, 2012 08:19am
What was the purpose of this lengthy article, any way?
s Dec 18, 2012 02:14pm
This is a common problem with ALL women ALL over the world and not just this region.
Arun Salian Dec 17, 2012 12:42pm
It has a positive side as well, World is already ex-hosted over population.
sradhanand Dec 17, 2012 12:18pm
It would be intersting to learn if young women in the pakistani side of Kashmir have the opportunity to have quality education