The cost of injustice
TO live in Karachi, or really any city in the tumultuous world that is our reality, is an exercise in dodging misfortune. When one leaves the house, one braces for survival. Traffic has to be navigated, angry or errant drivers avoided, beggars ask for money and there is filth on the street. By the time one reaches the destination, one is in a state of high vigilance. Dangers and disruptions are everywhere.
This means that most in the city live in a constant state of hypervigilance. Some would say that wealth can insulate a person from this avalanche of potential misfortune. There is material evidence of this: the wealthy have drivers who take them places, their cars and homes are cool with air conditioning and electricity outages are eliminated with generators.
They see the best doctors and eat the best food. If you belong to this class, the injustice that you see everywhere in a megacity is made distant. The maimed beggar, the dog being beaten, the woman wrapped in black trying to navigate a street full of men are things that exist in some different world.
The car window, the tall gate, the armed guard — these, it is assumed, make the cruelties of the context irrelevant. If they are considered, it is only in a calculation that assures you that your good fortune is deserved and those suffering must have earned it through some arithmetic of divine distribution.
The truth is that life in an unjust society exacts a cost. It does not matter how well you may take care of yourself; context matters. In her extraordinary book Weathering: The Extraordinary Stress of Ordinary Life in an Unjust Society, Dr Arline Geronimus has shown that the constant physical toll of coping with injustice can have deep physical and mental consequences. Naturally, the most disadvantaged suffer the worst consequences, but the effects of living amid inequality accrue on everyone in a society.
Diseased societies produce diseased people.
One category of disadvantaged people in Pakistani society is women. In a world in which patriarchy reigns, women are always playing defence. Marriage is a minefield where, if the demands of a husband or in laws are not met, every day can become a living hell.
A long list of dead women that I regularly write about in this column is evidence of this. If a woman is unable to bear a child for instance, she may either face divorce or her husband taking a second wife. If children do come, they can increase a woman’s dependence on her husband, making it harder to resist whatever strictures are imposed upon her.
The cost of all this is a constant state of vigilance, and Geronimus showed just how it can physically wear one down. Repeated activation of the stress response can disrupt hormonal regulation, raise blood pressure and contribute to inflammation. In the long term, this increases vulnerability to chronic disease and early death. Diseased societies produce diseased people.
A 2021 systematic study and meta-analysis found that 37 per cent of pregnant women experienced antenatal depression, while 30pc experienced postnatal depression. Intimate partner violence and poor relationships with spouses were among the reported risk factors. These figures can be attributed to the fact that women do not feel confident about their own or their children’s futures because they live in a society where injustice is common.
The most interesting thing about research on men and women in unjust societies is that men suffer too. Research examining sexism in US states has linked patriarchal contexts to poorer health outcomes in both men and women.
People believe that individual actions, status or material wealth can allow them to evade the conditions they see others endure. All this suggests that individual choices and wealth are not the biggest determinants of health in a society. Instead, it is the availability of collective justice and respect for life that affect health outcomes. This should give all Pakistanis pause. The poor are treated horribly, and we see terrible crimes committed against the weak every day. Women are regularly treated like chattel, children are routinely abused and caste and wealth determine the course of one’s life.
The worst curse is that we have learned to rationalise all of this, to absorb it as the way things are, the way things have been and the way things will always be. But being inured to injustice and quietly accepting of it is making us sick. Our tolerance of it creeps into our cells and our bones.
It is time we understood that there is no individual cure for these conditions and what ails us is a collective issue — deeper and more entrenched than improving our diets, quitting smoking or hitting the gym. Our habit of seeing so many wrongs and ignoring them is quite literally what is killing us.
The writer is an attorney teaching constitutional law and political philosophy.
Published in Dawn, October 31st, 2026
