Dr. Mohsina Bilgrami
..."Husbands and wives rarely spoke of these issues; wives quietly giving birth to children year after year with little attention paid to her health or what effect that might be having on the children," says Dr. Mohsina Bilgrami, managing director of the Pakistan chapter of Marie Stopes Society, the London-based nongovernmental organization
..."Things have changed in the last six or seven years," says Bilgrami, who has been working in the reproductive-health field for 22 years.
"People want healthy children, educated children who can go beyond what they themselves were able to achieve . . . and that has opened up more discussion on issues that are rarely discussed even inside the family."Bilgrami's organization
, the Marie Stopes Society
, is one of an estimated 200 nongovernmental organizations working on the issue in Pakistan.It operates 30 district centers, two dozens mobile clinics and employs 550 counselors, doctors and nurses, who provide pre- and post-natal care and gynecological exams and dispense contraceptives.
"In a historically conservative society, reproductive issues must be dealt with sensitively and there is no better way than to employ local people," says Bilgrami
"As a practice, the first people we approach in a new area are the clerics," Bilgrami
says, "and never once have I had any one of them argue with me.They too realize the importance of quality healthcare for child bearers."
Sterilization remains the most preferred method of contraception, Bilgrami
says, and usually only after a couple has had as many children as they desire.
Men, in fact, play a large role in the ongoing efforts to educate people in this male-dominated society.With the literacy rate for women at only 26 percent, compared with 50 percent for men, health workers reaching out to husbands as well as wives.Marie Stopes Society
clinics regularly treat male patients and run educational seminars.
"We get men riding up on bicycles, donkey carts and on horses demanding to see our doctors," Bilgrami