KARO-Kari is a type of premeditated honour killing, which originated in rural and tribal areas of Sindh. The homicidal acts are primarily committed against women who are thought to have brought dishonour to their family by engaging in illicit pre-marital or extra-marital relations.

To restore the so-called honour, a male family member must kill the female in question.

Although legally proscribed, socio-cultural factors and gender role expectations have given legitimacy to karo-kari within some tribal communities.

Besides its persistence in areas of Pakistan, there is evidence that karo-kari may be increasing in incidence in other parts of the world in association with migration. Moreover, perpetrators of ‘honour killings’ often have motives outside of female adultery.

An analysis of psychopathological factors associated with the practice of karo-kari can guide the development of prevention strategies.

Mental illnesses are also known to be associated with criminal behaviour. Psychopathy has been discussed widely in the context of criminality, especially in terms of its characteristic callous and unemotional personality profile. There is a support for the theory that psychopaths are associated with right hemisphere abnormalities for processing conceptually abstract material.

There are many possible explanations in terms of mental mechanisms for those who resort to crimes like karo-kari. However, there are a few questions that may arise. First, are perpetrators real psychopaths who, by definition, have a salient feature of ‘lack of remorse or guilt’? Are they insane? If yes, then, how are they left loose in the community? Are they mentally ill? If yes, then, why haven’t they come across mental health services?

It is understandable in the given cultural context where mental illness is still a stigma and most of the people will not give due importance to psychiatric disorder. Is it easy to rule out the possibility of ‘mass psyche’ disturbance? Can it be a social norm?

The answer to this cannot be a ‘yes’ as karo-kari is only endemic in Pakistan and in different forms at a global level. It will be no surprise if one day it would emerge as one of the new culture-bound syndrome, this time specific to Pakistan by the name of ‘karo-kari syndrome’, which may be explained in clinical terms as a sudden feeling of losing honour, feeling as if the powers are gone, extreme anger, irritability and wild impulse of killing the identified targets.

It may also reflect the pleasure principle of ‘Id’ which has remained immature and has not attained full evolution and transformation. This problem is being perceived wrongly by global observers and portrayed as if it is a part of the national psyche which meets the hidden approval.

Human rights activists have raised their voice in the media against it but it would also be appropriate if mental health professionals provide their input into the issue.

It is also surprising that the UN and WHO which stand for mothers and make policies to save women from dying because of health-related issues are so helpless in saving women who are killed on the pretext of karo-kari.

MASROOR HASSAN QAZI Larkana