08 November 2010

Backwards, as usual

Alissa Rubin has an article in The New York Times about divorce, the hard way, in Afghanistan:
Even the poorest families in Afghanistan have matches and cooking fuel. The combination usually sustains life. But it also can be the makings of a horrifying escape: from poverty, from forced marriages, from the abuse and despondency that can be the fate of Afghan women.
The night before she burned herself, Gul Zada took her children to her sister’s for a family party. All seemed well. Later it emerged that she had not brought a present, and a relative had chided her for it, said her son Juma Gul.
This small thing apparently broke her. Ms. Zada, who was 45, the mother of six children and who earned pitiably little cleaning houses, ended up with burns on nearly 60 percent of her body at the Herat burn hospital. Survival is difficult even at 40 percent.
“She was burned from head to toe,” her son remembers.
The hospital here is the only medical center in Afghanistan that specifically treats victims of burning, a common form of suicide in this region, partly because the tools to do it are so readily available. Through early October, 75 women arrived with burns — most self-inflicted, others only made to look that way. That is up nearly 30 percent from last year.
But the numbers say less than the stories of the patients.
It is shameful here to admit to troubles at home, and mental illness often goes undiagnosed or untreated. Ms. Zada, the hospital staff said, probably suffered from depression. The choices for Afghan women are extraordinarily restricted: Their family is their fate. There is little chance for education, little choice about whom a woman marries, no choice at all about her role in her own house. Her primary job is to serve her husband’s family. Outside that world, she is an outcast.
“If you run away from home, you may be raped or put in jail and then sent home and then what will happen to you?” asked Rachel Reid, a researcher for Human Rights Watch who tracks violence against women.
Returned runaways are often shot or stabbed in honor killings because the families fear they have spent time unchaperoned with a man. Women and girls are still stoned to death. Those who burn themselves but survive are often relegated to grinding Cinderella existences while their husbands marry other, untainted women.
“Violence in the lives of Afghanistan’s women comes from everywhere: from her father or brother, from her husband, from her father-in-law, from her mother-in-law and sister-in-law,” said Dr. Shafiqa Eanin, a plastic surgeon at the burn hospital, which usually has at least 10 female self-immolation cases at any one time.
The most sinister burn cases are actually homicides masquerading as suicides, said doctors, nurses, and human rights workers.
“We have two women here right now who were burned by their mothers-in-law and husbands,” said Dr. Arif Jalali, the hospital’s senior surgeon.
Doctors cited two recent cases where women were beaten by their husbands or in-laws, lost consciousness and awoke in the hospital to find themselves burned because they had been shoved in an oven or set on fire.
For a very few of the women who survive burnings, whether self-inflicted or done by relatives, the experience is a kind of Rubicon that helps them change their lives. Some work with lawyers who are recommended by the hospital and request a divorce. Most do not.
Engaged at 8 and married at 12, Farzana resorted to setting herself on fire when her father-in-law belittled her, saying she was not brave enough to do so. She was 17 and had endured years of beatings and abuse from her husband and his family.
Defiant and depressed, she went into the yard. She handed her husband their 9-month-old daughter so the baby would not see her mother burning. Then she poured cooking fuel on herself.
“I felt so sad and such pain in my heart and I felt very angry at my husband and my father- and mother-in-law, and then I took the matches and lit myself,” she said.
Farzana’s story is about desperation and the extremes that in-laws often inflict on their son’s wives. United Nations statistics indicate that at least 45 percent of Afghan women marry before they are 18; a large percentage before they are 16. Many girls are still given as payment for debts, which sentences them to a life of servitude and, almost always, abuse.
A bright child whose favorite subjects were Dari language and poetry, Farzana dreamed of becoming a teacher. But she had been promised in marriage to the son of the family that was providing a wife for her brother, and when she turned 12, her in-laws insisted it was time to marry. Her future husband had just turned 14.
“On the marriage day, he beat me when I woke up and shouted at me,” she said. “He was always favoring his mother and using bad words about me.”
The beatings went on for four years. Then Farzana’s brother took a second wife, an insult to Farzana’s in-laws. Her mistreatment worsened. They refused to allow her to see her mother, and her husband beat her more often.
“I thought of running away from that house, but then I thought: what will happen to the name of my family?” she said. “No one in our family has asked for divorce. So how can I be the first?”
Doctors and nurses say that especially in cases involving younger women, fury at their situation, a sense of being trapped, and a desire to shame their husbands into caring for them all come together.
This was true of Farzana. “The thing that forced me to set myself on fire was when my father-in-law said: ‘You are not able to set yourself on fire,’ ” she recalled.
But she did, and when the flames were out, 58 percent of her body was burnt. As a relative bundled her raw body into a car for the hospital, her husband whispered: “If anybody asks you, don’t tell them my name; don’t say I had anything to do with it.’”
After 57 days in the hospital and multiple skin grafts, she is home with her mother and torn between family traditions and an inchoate sense that a new way of thinking is needed.
Farzana’s daughter is being brought up by her husband’s family, and mother and daughter are not allowed to see each other. Despite that, she says that she cannot go back to her husband’s house. “Five years I spent in his house with those people,” she said. “My marriage was for other people. They should never have given me in a child marriage.”
Why do women burn themselves rather than choose another form of suicide? Poverty is one reason, said Dr. Jalali. Many women mistakenly think death will be instant. Halima, 20, a patient in the hospital in August, said she considered jumping from a roof but worried she would only break her leg. If she set herself on fire, she said, “It would all be over.”
Self-immolation is more common in Herat and western Afghanistan than other parts of the country. The area’s closeness to Iran may partly explain why; Iran shares in the culture of suicide by burning.
Unlike many women admitted to the burn hospital, Ms. Zada showed no outward signs of distress before she set herself on fire. Her life, though, was hard. Her husband is a sharecropper. She cleaned houses and at night stayed up to clean her own home — a nearly impossible task in the family’s squalid earthen and brick two-room house buffeted by the Herati winds that sweep in a layer of dust each time the door opens. To her family, she was a constant provider. “Before I thought of wanting something, she provided me with it,” said Juma Gul, 32, her eldest son, a laborer who earns about $140 a month. “She would embroider our clothes so that we wouldn’t feel we had less than other people.” As he spoke, his 10-year-old twin sisters sat near him holding hands and a picture of their mother.
In the hospital, Ms. Zada rallied at first, and Juma Gul was encouraged, unaware of how hard it is to survive such extensive burns. That is especially true in the developing world, said Dr. Robert Sheridan, chief of surgery at the Shriners Burn Hospital in Boston and a trauma surgeon at Massachusetts General Hospital. The greatest risk is sepsis, a deadly infection that generally starts in the second week after a burn and is hard to stop, Dr. Sheridan said. Even badly burned and infected patients can speak almost up to the hour of their death, often giving families false hopes.
“She was getting better,” her son insisted. But infection had, in fact, set in, and the family did not have the money for powerful antibiotics that could give her whatever small chance there was to survive. Juma Gul eventually managed to beg and borrow the money, but not before the infection spread. Two weeks after his mother set herself on fire, he stood by her bed as she stopped breathing.
Rico says that these abused ladies have got it backwards: if they'd set their fathers and husbands on fire, instead of themselves, things might well change...

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