War against polio or polio workers?

The Tehreeq e Taliban Pakistan (TTP) launched an effective and violent campaign against polio vaccination during their occupation of Swat. Apologists insist that this violence be viewed in the context of the 'war on terror', but refuse to engage with the connection, merger and impunity that the TTP’s narrative lends to other faith-led political violence in Pakistan.

Afiya Shehrbano Zia
2 January 2013

Barely two months after the shooting of Malala - the girl targeted by the Taliban in Swat for “secularizing society” through her campaign to promote girls’ education - nine people responsible for administering the government’s polio vaccination campaign were shot dead in different cities of Pakistan. It was part of a coordinated and planned assassination plot executed in less than 48 hours. Five of the murdered workers were women. Although the TTP had proudly and publicly confessed to the assassination attempt on Malala, and justified their motivation as an attempt to stop her “secularization” agenda, they have denied responsibility for the killings of the polio workers.

Pakistan’s feminists and human rights activists have protested the specific abuses perpetrated by the Taliban, but moreover they have pointed out the overlap of all militant groups’ rhetoric, agendas and violent strategies, with those of mainstream religious fundamentalist groups and clerics. However, critics of human rights activists accuse them of ‘demonizing’ the militants and religious fundamentalists, and argue for contextualizing such violence in “the web of social, economic and political power relations within which acts such as these are embedded”.

I shall attempt to follow this advice as I write here and highlight the ‘context’ which enabled such unprecedented violence against female health workers, ostensibly committed by militants other than the TTP.  I shall argue that it is not just the “conditions that create groups like the Taliban” that require scrutiny, but that it is equally incumbent upon us to see how the narrative of religious militancy encourages, strengthens, colludes with and affords impunity to all forms of faith-based misogyny in Pakistan. 

Lady health workers in northern Pakistan

Between 2006-2009, the Taliban’s invasion of Swat in the Himalayan region of Pakistan was followed by its systematic and violent pogrom to enforce its version of Sharia’h on the already Islamic Republic of Pakistan. The Taliban destroyed Swat’s famed tourist industry through a series of public beheadings and hangings (of prostitutes, barbers and entertainers) in town squares. Once they controlled Swat, over their three-year siege, the Taliban prohibited polio vaccination campaigns, destroyed 165 girls’ schools, 22 barber shops, and banned all music, cinema and most NGOs in the area. According to some reports, health workers were also killed by the Taliban as they attempted to save people wounded in suicide blasts. The lady health workers  (LHW) -  a team of over 110,000 trained female community workers delivering basic health services at doorsteps in communities since the programme was initiated by Benazir Bhutto’s government in 1994 -  in the Taliban-controlled areas, were specifically targeted by the militants.

In a British Medical Journal (BMJ) study on 'How the Taliban undermined community healthcare in Swat, Pakistan,' the authors conducted in-depth interviews with Swat-residing Pushtoon women health workers to gauge the effects of the Taliban’s threats and violence against them. Not only did the overall infrastructure of community health suffer drastically, but maternal mortality increased, and individual LHWs were socially ostracized through a vilification campaign, while many left or stopped working due to direct threats to their lives.

Some of the strategies adopted by the Taliban are quoted in the study, based on the direct experiences of the affected health workers  (although the authors make the proviso that the worst affected could not be interviewed due to the high risk this entailed for those women’s lives). The most effective strategy employed by the Taliban was to “name and shame” the female health workers on FM radio and the issuing of three fatwas (religious edicts) against them.

The study notes that these religious pronouncements had a more serious impact than even the threats of kidnapping, execution of forced marriages and in some cases, death. The reason is that these fatwas were not directed at health services per se but against the very notion of women in public spaces, which was declared a form of public indecency. The fatwa also declared that, “it was a Muslim man’s duty to kidnap the women health workers when they paid home visits, to marry them forcibly even if they were already married women, or to use them as sexual slaves” - maal e ghaniymat – spoils of war.  Specifically, Maulana Fazlullah, the Taliban chief of Swat, (often described as a kind of revolutionary Che Geuvera in some apologetic scholarship) even went so far as to declare the LHWs wajibul qatl - fit for murder.

The second fatwa declared it was illegal for Muslim women to work for wages, and the third fatwa that lady health workers  were subverting the gendered social order because they travelled unaccompanied, door-to-door, “acting like men.” These ‘divine’ rulings were instrumental in discrediting the primary care work because the health workers were now cast as “prostitutes” and “servants of America.” The Taliban’s (now famed) use of the FM radio for religious propaganda, rationalized that since these women health workers carry condoms it was obvious that they were house-calling prostitutes.

In varying degrees, the substance or rationalization of all three fatwas overlap, and can be found in the rhetoric employed by several hard-line and mainstream Islamists. When the Taliban occupied Swat, the Islamist alliance party, the Mutahida Majlis e Amal (MMA) was ruling the northern province of Khyber Pukhtoonkhwa (2002-2008). Their governance is best exemplified by the Hisba Bill, vetoed by the President, which attempted to institute gender apartheid through a virtue and vice police to severely restrict women’s mobility in public. The MMA women representatives ( largely from the Jamaat e Islami) once in power, worked towards actively subverting most constitutional rights for women, including the right to vote, and in closing down women’s shelters and NGOs working on women’s empowerment.

The fate of the lady health workers

The women health workers (LHWs) interviewed in the BMJ study cite specific examples of beheadings,  as well as public beatings and firing on their houses and murders of their colleagues’ family members. The study notes that the LHW programme to provide family planning services made it “an ideological target.”

This is very similar to the campaigns and political positions taken by some mainstream Islamists who argue that family planning, contraception and sex education promotes “vulgarity”, “obscenity” and encourages extra marital sex. Maulana Fazlullah argued that, “LHWs want to promote prostitution and sins in our society.” According to the BMJ study, about 15% of the LHWs of Swat resigned, others simply stopped working while several left the city. The effect of the Taliban’s persecution of the health workers resulted in an increase in maternal mortality, at least seven forced marriages (according to the sample interviewed), and abortions have been on the rise. This information came to light in the aftermath of the army operation in Swat which forced the Taliban out in 2009.

Feminists in Pakistan have for decades framed their activism within a gender-based understanding of, and campaign against, honour crimes, acid-throwing and rape. They have also resisted the conservative dictates of religious political groups, and protested their silence on violence against women in the domestic and public realms. However, since 9/11, considerable international scholarship tends to view all events in Pakistan through the singular lens of the 'war on terror'.  This tempts scholars such as Nivi Manchanda to argue for a specific attention to epistemic violence that the region has been subjected to, rather than the “individual agency underscoring such acts of violence”.

This defensive prescription only surfaces in response to crimes committed by religious militants or in the name of religion. The difference between this appeal and Pakistani feminist analysis is that while understanding the cultural and political context, feminist activists do not subscribe to cultural or geo-political specificity as an excuse to exonerate the crime. While recognizing and locating the contextual roots and material basis of patriarchal violence, and noting its links to masculinist imperialism, feminists also seek to hold accountable the actors and expressions of such violence.

The suggestion that violence perpetrated in the name of Islam can no longer be viewed as a crime, committed by individuals, aided and sanctioned by local Islamist clerics and groups is dangerous. Such accusation defuses the criminal act as an imperative of a ‘broader discourse’ and depicts feminists and human rights activists as alarmists who focus exclusively on faith-based violence.

If this is an accurate allegation, how should feminists be advised to respond to crimes such as the flogging and stoning of women, the murder of a 64 year old Swiss woman in Punjab who served as a church affiliate charity worker for 14 years, or 14 year old Malala, who resisted the Taliban’s anti-girl’s education campaign, or women who “roam the streets” administering polio drops to children in poor neighbourhoods?  Does one subsume all gendered violence as stemming from “a broader discourse… of heteronormativity… and neoliberal development”? How do we apply this prescription when such violent acts are urged, sanctioned and supported by mainstream clerics?  Should we remain silent on how anti-polio and contraception campaigns have been continuously and historically linked with the narrative of religious fundamentalism and conservatism?

Responsible analysis

The killings of the polio workers may or may not have been the work of the Taliban, but their narrative of anti-polio campaigns is consistent with that of religious fundamentalists in Pakistan. The main religious political parties support polio vaccination (since they proclaim to be anti- fundamentalist) but never condemn the Taliban for their atrocities in this regard. Are critics intellectually honest enough to identify all those crimes against women which are directly connected to religious fundamentalism? Or is the suggestion that violence cannot be inspired by religious fundamentalism and should only be seen as motivated by and reactive to imperialism? Are religious actors empty vessels and religion void of political agency?

It would be far more interesting if critics of neoliberalism were willing to make the case that polio vaccination and girls’ education/political empowerment are in fact very much part of the neoliberal development agenda. If so, why stop at the observation? Should the advice not be then to review anti-polio, anti-education drives as part of a rational rejection by those who oppose health and education programmes, particularly for and by women, because these are part of the trope of liberal universalism? This form of rationalization allows any militant who claims to act in the defense or promotion of Islam to be absolved of ‘criminal intent’, or from being called violent, and to be viewed as a permanent victim of external conditions and a ‘global political climate.’

Most prominent feminists in Pakistan affiliate themselves with, or have been part of, a leftist political leaning. To suggest that they are not aware of the history or imperialist trappings that have produced forces such as the Taliban, is a deliberate oversight. The accusation that feminists cunningly set up binaries by propping up all Islamists as evil, and themselves (women/victims) as secular innocents, serves only to assist a new generation of academics to position themselves as ‘objective’ commentators on the reinvention of Islamic politics in Pakistan. However, this is a politically and historically truncated project. By only focusing on the post 9/11 era, the politics of religion and its instrumentalization by organized groups and the state, is cast in the dustbin of history.

It is this kind of commentary that pretends that the resistance to polio vaccination has peaked because a fake vaccination campaign was staged as part of a CIA dragnet operation to hunt and kill Osama Bin Laden in 2011.  The OBL raid has definitely contributed to a different kind of political mistrust of the campaign, and is unconscionable. But it does not explain or condone the historic and simultaneous oppositional strategies and violence meted out against women community workers by religious clergy and/or militants. 

What happens next?

Female mobility, knowledge of sexuality, and financial independence is a threat for most men in Pakistan. Therefore, the in-roads made by the hundreds of thousands of women serving communities that have little or no access to very basic health care cannot be underestimated. The work of women health workers has met with resistance from large landowners, as well as local clergymen, but the state has been instrumental in extending assistance through local police support to the women workers during the polio and maternal health campaigns. The resilience of the health workers also makes remarkable documentation - the most recent evidence being a mass campaign demanding a minimum wage and the regularization of their jobs.

The critics who seek to deflect the need to specify the threat of religious militancy, and view all such crimes as simple causative links to the war on terror and ‘US-imperialism’, can draw comfort in the fact that the World Health Organisation and Unicef have aborted the polio vaccination campaign since the murder of the polio workers. An estimated 3.5 million children were missed out of the last rounds of vaccination and the interruption is certain to add to the figure this year.

The Saudi government has an interesting ‘alternative’ approach to ‘imperialist’ programmes, such as universal health, of which polio eradication is one aim. At the time of Hajj, the Muslim holy pilgrimage, the Saudi government administers compulsory polio drops to all pilgrims from Pakistan, Nigeria and Afghanistan at their entry ports, based on the suspicion that they may be polio carriers. The World Health Organisation has made repeated appeals directly to the Pakistan Taliban to lift their ‘ban’ on polio campaigns in the country.

The proposal that we must not hold the immediate perpetrator ‘caught on the scene’ as responsible for his crime, exonerates not just Islamic fundamentalists who are often the ones behind the scenes ( the rationalisers, the fatwa-issuers, the sanctifiers), but all actors of crimes against women. If we agree that the ‘political climate’ must not be ‘blanked out’ and violence against women must be contextualized as part of a ‘broader discourse,’ then the attacks by religious militants on women polio workers (and other women activists), must be seen in the context of the views, politics and policies of all Islamists on women’s health, sexuality, homosexuality, control over their bodies, mobility and gendered roles. Only then can we be assured of a more accurate analysis of gendered violence in Pakistan.



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