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The ratio seems unbelievable: according to a US study, the proportion of men and women in Pakistan is 111 men per 100 women — fully 11 men more for every 100 women. This makes it one of the most unequal and unusual sex ratios in the world.

This discrepancy is particularly obvious among people over 50, where men account for 7.1 per cent of the country’s total population, and women for less than five per cent, apparently reflecting the fact that women are dying in much larger numbers at younger ages (or that their births and deaths are not always documented). The figure also reflects their lack of access to quality medical care.

It can be argued that the inverse ratio is at least partially responsible for the prevalent negative attitudes and mindset towards women, their secondary status, and the continuation of laws and policies that negate women’s personhood and rights. The reasons for the anomalous ratio need to be probed, including those that impact women’s lives.

Only two other countries in the world have similar inverse sex ratios — India and China. Like Pakistan, they too have a marked preference for sons, considered a prime reason for high population growth. Pakistan’s own data states that the overall sex ratio is 102 men per 100 women, which the publication itself considers implausibly high, attributing it to a tendency to under-report women.

The world average is the opposite — there are more women than men in other parts of the world, due to their greater biological strength and resistance to infections, which provide protection throughout the growing years, up to the menopausal stage. In the developed world, this natural phenomenon is further supported by optimal health care. The world average is 104 women for every 100 men.

In Pakistan, several factors may contravene these estimates: during the last decade, two natural calamities, the earthquake in 2005 and the floods in 2010, affected the entire country, resulting in numerous deaths and high levels of internal migration. Even under normal circumstances, relatively high rural to urban influx of the population is regularly on-going. Migration of agricultural labourers traditionally occurs at various harvest times.

Conducting surveys is rendered difficult by migration, and also by culture: enumerating the precise number of females is problematic; men are reluctant to provide information about the women in their households.

The Human Rights Commission of Pakistan official and eminent journalist, I.A. Rehman points out the high demographic impact of female infanticide, maternal mortality, honour killing and death resulting from violence against, and abuse of women. Edhi and Chhipa voluntary services report that newborn babies are still thrown into garbage dumps — and the majority of them are girl babies. Nor has there has been any reduction of women’s deaths due to violence and abuse, including acid burns, ‘stove bursts’, and honour killing.

Women’s higher mortality also stems from chronic malnutrition, life-long neglect of health, and physically demanding workloads. Early marriages — even now the norm in at least 10 per cent of the population — are invariably followed by multiple childbirths to young girls and women who are least prepared, either physically or mentally, to cope with the rigours of child-bearing and child-rearing. Despite a few social safety nets, woefully inadequate health policies and programmes, non-availability of satisfactory health facilities and medical expertise, particularly in rural areas, fail to address the critical immensity of the problem.

Like the vicious poverty cycle, Pakistan’s inverse sex ratio is endemic and cyclical: gender inequality, subservience and gender based violence remain insufficiently addressed by current policies, programmes and legislation. Education, which could have helped lift more than 50 per cent women out of poverty, has been criminally denied them, by their families and by inadequate education infrastructure. The combination negatively impacts women’s empowerment and growth, which again promotes women’s secondary status.

Possible repercussions of this adverse sex ratio include men’s greater recourse to sex workers, and increasing incidence of STDs and HIV/AIDS. In 63 years, this country has still not been able to establish a decent system for women’s education, health or population planning. More than half of Pakistan’s women are uneducated; 76 per cent expectant women are forced to rely on themselves at childbirth, sometimes with the help of traditional midwives, at other times not even that. Inevitably, deaths during pregnancy and delivery are significantly high — facts that probably render that inverse ratio true.

However, the US study admits that these figures are estimates. Perhaps the truth will only emerge in the forthcoming census: the last one, due in 1991, was postponed to 1998, due to unrest. The present census is already underway. The census truth may reveal that the ratio of men to women lies somewhere in between 102 men per 100 women, and 111 men per 100 women, a statistic which is still cause for serious concern.

Distressingly, women have suffered greater systematic neglect and decimation: the consequences to society are likely to be worse. The public and the powers-that-be are together responsible for this harsh violation of women and their human rights. Can they accept this challenge, and work to rectify it?