Background: The context for this discussion is preparation for a consultation on faith and development in South and Central Asia, held in Dhaka, Bangladesh, on January 10-11, 2011. The consultation is an endeavor of the World Faiths Development Dialogue (WFDD) and the Berkley Center for Religion, Peace, and World Affairs at Georgetown University, with support from the Henry R. Luce Foundation. Its aim is to take stock of the wide range of ongoing development work by different organizations that are, in varying ways, inspired by religious faith, but more important, to explore the policy implications that emerge from their interactions with other development organizations. The interview was conducted in Washington, D.C. between Michael Bodakowski (WFDD), Melody Fox Ahmed and Sara Singha (Berkley Center), and Zebu Jilani, President of Swat Relief Initiative. Ms. Jilani reflects on the role of faith in development in the Swat Valley, particularly in the response to the 2010 floods in Pakistan, the activities of international development agencies, and the role of the Pakistani Diaspora. Ms. Jilani emphasizes lack of coordination as a major impediment to effective relief work. She notes the influential role that faith leaders play in their communities and the importance of involving them in development programs.
How did you come to found the Swat Relief Initiative?
I grew up in Swat, known here as the Swat Valley. I came from a family that was part of developing Swat; my grandfather was the last ruler of Swat and my great grandfather founded the state. Swat was basically a tribal area, very underdeveloped. Because of their vision to make Swat into a modern state, they brought in schools and clinics, infrastructure such as roads, and a justice system; they brought Swat into the modern era. Thus our family has a long history of working for Swat.
I was sent to a Catholic boarding school in Murree, northeast of Islamabad, when I was five. My grandfather was intimately connected at that time with women’s rights. If he saw any woman suffering or any case of child marriage, he made it a point to help them. As children, we lived with my grandfather, and we saw odd situations, such as seven year olds married to 80-year-old men, and women denied property rights because they had no male children or because their male children were too young. In some extended families, relatives would also try to kill the minor children of deceased male relatives, in order to steal their inheritance. Such women came to our house asking my grandfather for help. Every time I saw them, I felt that I had to do something for the women of my country.
At the age of 26, I got married to my husband, who was living in the United States, and moved here. Thus I had never had much opportunity to help my people. Nonetheless, I maintained a scholarship program for women who were hardworking; I have financed the education of ten women a year.
This situation changed abruptly when a massive human displacement from Swat took place in the first half of 2009, following a large scale military confrontation between the Pakistani military and the Taliban, when the latter tried to establish a stronghold in the Swat valley. Approximately two million people were displaced, with many unable to return after the fighting subsided. It was at this point that I decided to get more organized and formed the Swat Relief Initiative to help the internally displaced people (IDPs) directly.
My background is in nutrition. I formalized my years of reading and informal nutritional practice with a degree in 2005. We were based in the Cleveland, Ohio, area at the time, and I worked at a number of establishments there before my husband’s transfer to Princeton, New Jersey.
Building off of this experience, we were able to start work as soon as we arrived in Mardan, Northern Pakistan, where the IDPs were. Many of them were in formal camps set up and supported by the Red Cross and other international aid organizations, but most were in informal, unsupported “camps” in open fields, school yards, individuals’ homes, etc. We formed two mobile health units and went to these unsupported locations; they were simply not on the radar of other aid agencies. We would find these locations via our contacts among the IDPs, who also gave us tremendous insight into the real issues facing the communities. We decided to focus our effort on these areas.
The main difference between us and other organizations was that we hired people, generally IDPs themselves, from the local Swati community. We recruited nurses, doctors, and other health professionals, and formed our team. We were not able pay them much, but because they were so motivated to help their own people we were able to provide a much needed service to the IDPs. Our three basic principles were community mobilization, keeping costs down, and not creating dependency. With this in mind, our highly motivated team helped their own people, and because we had no language barrier, we were able to see over 400 patients a day, while other organizations were only able to see around 100 patients a day. Thus we were truly able to utilize our home-field advantage. We also distributed supplies and rations.
This year, I went back to Saidu Sharif, Swat, to start a preventive healthcare program among the people, who by now, had returned to a war-ravaged homeland. We felt that through community mobilization we could help people take charge of their health and thus help themselves.
How did the health initiative work?
By the summer of 2010, we had funds, local support, and a very good facility in Swat. We had an extensive local network and knew how to mobilize support. We also partnered with an organization called the Human Development Foundation, which is very popular with the Pakistani community in the U.S. They offered us technical support; the relationship worked very well. I attended their seminars and training programs. Thus I was able to form my own program that dealt with nutrition, family planning, how to rear children, disease prevention, and hygiene for the local population. We set up a format where we went to villages to train people. Other organizations would set up medical camps where they handed out medicines to people who had no training on how to take them. They would simply write down the instructions, but a lot of these people cannot read. Our policy was that we would ask the recipients to repeat the instructions three or four times to assure us that they understood how to take the medication.
People in Swat told us that the most important benefit to them came from the health seminars that we conducted. As part of the seminar curriculum, we identified some important micronutrients that were missing from their diet and introduced them to the subject. We also taught them how to grow their own vegetable gardens, and how to make compost. So we were basically helping them take charge of their health because they had become so reliant on doctors and had forgotten their own traditional ways. We reminded them that just two or three generations ago their parents and grandparents ate whole wheat and herbs and that they took charge of their nutrition and grew their own vegetables. You, we told them, are too reliant on doctors. We advised them to stop using adulterated spices, flour, and tea because these things were bad for them. Once all of this was pointed out to them, they were very receptive to the program.
My team appreciated the fact that I was going around with them myself, because our family has a lot of credibility in the community and they were pleased that I was so engaged.
The main goals for our preventive healthcare are in line with the UN Millennium Development Goals, which aim to reduce infant mortality, improve maternal health, and combat major disease. We run programs of inoculation awareness, and we train health professionals to go into the field and reach out to women. A lot of the women are very secluded because their men do not allow them to come to hospitals. So we go to their homes and teach them about these things.
What are the practical implications of faith and religion in the work that you do and the regions where you work?
In recent years there has been a major effort to spread the Wahhabi Muslim message in Pakistan. Wahhabis use selective passages in the Qur’an, taken out of context, and references to unreliable hadith, to convince the people that their very narrow, repressive, interpretation of Islam is the right one. This is happening in a region which has, for centuries, been a bastion of the more spiritual, Sufi form of the religion. Undereducated mullahs are funded by Wahhabi-based movements and are trained in their narrower interpretation of Islam. This has caused enormous strife and confusion among the general public, religious institutions, and the government. The Taliban movement and related wars are a direct result of this. Recognizing this reality on the ground, a segment of our seminars focuses on Quranic passages that convey the messages of eating pure foods, longer nursing periods for babies (a natural birth control), and that fasting is prohibited for the sick, the elderly, and travelers.
As an example, in order to encourage breast feeding, maternal nutrition, and family planning, we point to the passage 2:233 in the Qur’an which advises mothers to nurse their child for two years. This benefits both the mother and child. We explain that the child benefits by getting the perfect food—mother’s milk—and that the mother benefits because breastfeeding is a natural birth control and the two-year timing protects them from frequent pregnancies.
For child rearing, we quote passages from the Qur’an which emphasize how great a responsibility parenting is. We explain that the Qur’an says that children have certain rights over their parents. These are the rights to loving care, enough nutritious food, a good education, and to be taught right from wrong. If parents are not fulfilling to follow these injunctions prescribed for them, they are not fulfilling their responsibilities. Thus they are going against the Qur’an and are a detriment to their children and the community as a whole. We try to frame topics in this way so that people can better relate to them.
What roles do religious leaders and faith communities more generally play in relief and development work? Have you coordinated with them or gone into dialogue with them in your work?
We have tried to talk to the religious leaders and engage them, because they are presently a detriment to development. For instance when the recent floods hit Pakistan, people went through an enormous trauma, and many became very sick. The floods began in July 2010, and at their height left approximately one-fifth of Pakistan under water, affecting over twenty million people. Ramadan, the Muslim month of fasting, began soon after this. Mullahs were telling people that even if they had one breath left in them, they had to fast. We taught, with the relevant passages from the Qur’an, that to God, health is paramount and that the Qur’an clearly states that there is no fasting for sick people, or while traveling, or when old or menstruating, because fasting would make them sicker. We urged people to follow what the Qur’an, not what the mullahs, says. We tried to explain to the mullahs and the community that they could still be faithful to the Qur’an while minding their health. But not all the mullahs are educated, and the message is difficult to convey as a result; we continue to work with the mullahs so that they do not preach what is not in the Qur’an.
What can large international development organizations and donors do to engage religious leaders and actors more effectively in their programs and in dialogue?
I doubt that international agencies can engage the mullahs directly. When I was in Pakistan, the word NGO was seen almost as a curse word, because the NGOs did not have programs tailored to local circumstances and were seen as corrupt. Religious leaders and communities had, not unreasonably, become disgruntled with their programs. Given the negative connotations about NGOs and projects they support, we try not to use word NGO in our work. We described ourselves as an “Organization” rather than an “NGO.” That has made some difference. In order for international NGOs to be more credible and effective, one way is to seek out overseas Pakistanis, originating from the regions that the NGOs are working in, to return for manageable periods of time. The overseas Pakistanis can help provide a higher standard of ethics and work directly via their home networks to form the right partnerships with the necessary religious leaders in the area.
Turning back to your work on health, you mentioned a visit to a maternity ward, an experience that shaped your thinking and present work. Could you tell us this story?
One of our most ambitious goals is to improve maternal health. We monitor expectant mothers and lactating women. If they cannot have their babies at maternity homes, then we refer them to hospitals. I cannot begin to share the horrors I saw when I visited a maternity ward. It was the worst experience I have ever had. It was a government hospital in the main city in Swat, where all the poor people come for treatment.
Several billion dollars came into Swat over the last 18 months. Unfortunately, there is not much to show for it. If the government wanted to improve women’s health, then the first place they should have started was the district’s maternity ward. When I visited the ward, there were no antiseptics and nothing to sterilize medical instruments with. The same unsterilized instruments were being used on multiple patients. The beds were tiny and the poor women were literally falling off. There were no sheets on the beds and blood was everywhere. The same suction cups were being used for many women without being sterilized. The stench from the bathroom was so overpowering that it made me feel faint. There were feces and urine flowing out of the bathroom and into the corridor. I have never seen anything so horrific.
I was told that I should stand out of sight to witness how the patients were being treated because sometimes they were treated better when someone from outside was watching. So, I stood there for a half an hour, incognito, and watched how the staff treated the patients. They abused them, slapping and shouting at them; I couldn’t believe the way that the women were treated. These are the people that are the poorest of the poor and have no one to advocate for them.
I decided to do something about the hospital. We have since managed to get five million rupees (about $60,000) for the hospital from three main organizations: The Concerned Citizens of Pakistan, the Rotary Club, and NRSP (National Rural Support Program). We have hired staff, including doctors, midwives, and cleaners; we monitor this staff, and the hospital provides us with weekly updates. We have given the staff training on ethical behavior, standards for cleanliness, and hygiene, etc.
Was there any conflict with the government?
No, not at all. The government is very laid back. We basically took over the maternity ward and they said that we could do what we wanted with it, that it was ours now… That is the way the government works in this region. If you want to do anything to implement change, you have to do it privately. Before we got there, they had one cleaner for the entire maternity ward. One cleaner for the entire hospital! To clean the bathrooms, the beds, the floors—everything was done by one person. So, how much can one person do? I asked the hospital, “Can’t you appeal to the government to send you more cleaners?” They said no. There is so much red tape and so much effort involved that they were not going apply for it.
The army heroically transported flood-affected people from remote areas to the hospital. However, when the people arrived they had no money and could not afford the medicines they needed for surgery. We were able to provide these people with the necessary medicines or emergency cash where needed. We had wanted to reach the remote areas that we knew needed help badly, but had no way to get there ourselves. However, with the army bringing these people to the hospitals, we were able to provide the necessary help.
What gender challenges facing Swat did you see? How do they reflect issues for Pakistan more generally? How do you see the role of religion in this area?
One of our goals is to make people conscious of gender inequality. Gender inequality is the rule in a place like Pakistan and especially in remote districts like the Swat Valley, because it is a very rural area. The health of boys is always better than that of girls, because when food is served, women feed the men first, then the rest of the children, and if there is a little bit left over, then they feed themselves. There is a lot of inequality and difference in the way the boys and girls are treated in the family. In some instances, the mothers perpetuate this kind of behavior. They treat their sons differently from the way they treat their daughters. For instance, the sons are not raised to work in the house or if they do work, it is not regularly, whereas the girls do all the work. A mother tells her daughter to do everything for her brother—to serve him food and wash his clothes. The boy becomes the little king of the house and the girl is like the servant. There is a lot of disparity between the treatment of women and men as well; the men begin to dictate to the women what they must do as they grow older. So, basically, the boys become the lords and the girls become the slaves. This is an important area where we are trying to influence and bring change for the better.
We emphasize that the Qur’an teaches equality of men and women. People, however, tend to treat their sons differently because they think that their sons will take care of them and will provide an income when they grow older. If the family has access to education, they will not educate the girls but they will educate the boys. We point out to them that in the Qur’an there is gender equality and they have to treat their sons and daughters alike. We tell them that they have no idea about the future, and if they educate their daughters, they too might bring income to the family, perhaps even higher than their brothers. We talk to the mothers and say that if they want to improve their position in society, they must treat girls with equality and respect.
How has conflict affected your work, and what peacebuilding initiatives seem to be the most effective? How are faith actors involved, and what are some of the challenges?
Conflict has forced us to adapt the lens through which we plan our development programs. The conflict had, as I discussed earlier, created a human displacement emergency; nearly two million people did not have access to basic human needs, including shelter, food, and basic health and sanitation. During the displacement, immediate survival was foremost on people’s minds.
That being said, the environment is not yet ripe for peace-building efforts to begin. Once people’s basic needs are met, we can transition from short-term relief activities to sustainable long-term peace-building projects. Through our relief work, we are building relationships and networks with a diverse range of community members; after immediate needs are met, we can tap into these networks to initiate peace-building programs.
In urban areas, including Islamabad, that were not directly affected by the conflict and floods, some peace-building initiatives are underway. My niece is doing work in Islamabad on communal strife, with plans to address specific areas of tension and conflict between different Sunni sects and Sunni-Shia conflict. Once her programs begin to get traction, and the flooding and violence in rural areas subside, we can think about implementing peace-building programs in rural areas.
Do you have much interaction with international development organizations, and how have you experienced their work?
International development organizations are actually wasting most of their money because there is no oversight of programs. We noticed this in the field. Western organizations hire local people to do the work, but they themselves do not travel into those areas to be role models and set high ethical standards. The entire emphasis seems to be on making money; helping people appears to be a secondary goal. This is the case all over Pakistan. In general, the projects we are seeing are not long-term and sustainable, sometimes having nothing to do with the real needs of the people. These organizations are usually filled with people that come up with programmatic ideas far away from where catastrophes occur, without really understanding the realities on the ground. They go to a foreign country, set up shop with huge salaries that are not in line with the local community and economy, creating a lot of resentment in the local population.
What are some of the organizations in Swat that you came across or that you worked with that are working in ways that you just described?
One was the World Food Program (WFP). Before the floods, the WFP were in the area and gave authority to local managers, but again, there was a lack of oversight. For example, the WFP had started an incentive program to increase student attendance in schools. They did this by providing food rations to each student who attended school. The unintended consequence of this was a sudden, unplanned increase in students, in some cases one hundred students to a teacher, which made teaching impossible. After the floods, a lot more food was brought in and distributed to people who did not really need it, creating an unnecessary dependency. The method of food distribution was such that it ensured that fittest, least needy were supplied with the weakest and most needy going hungry. We have been in touch with WFP, as well as other organizations like Mercy Corps and World Relief; we have explained to them our concerns and have suggested ways to resolve these issues. We have described to them how we have had some successes without developing the issues that were created by their effort.
As an organization, being from the region and having extensive contacts, we had the advantage that we had a lot of local people helping us; we were able to recruit 100 volunteers in just one hour and send them out into the field. Our volunteers then identified people that needed food and would send us the lists; we would then go with them to double-check the lists. Oversight and local knowledge helped extensively in implementing our programs.
It was not easy to reach remote communities. We had to climb mountains to get to the people most in need. It was better to go to them, however, because to make these people stand in line and then have to fight for rations would rob them of their dignity. When we received money for rations, we located wholesalers, and through them, ordered basic necessities for one month per family. We then issued coupons to the needy people who, under our arrangement with the wholesaler, would collect the rations.
One problem we faced was that a lot of material donations we received were often either not practical or were damaged. On one occasion we received food for 800 people. We discovered that the bottled water had leaked and had wet the packets of flour, so they couldn’t be used. This was a tremendous waste. With the money spent on these unusable supplies, we could have fed more than 3,000 families.
What is the role of Diaspora communities in development, relief, and peacebuilding work?
Within Diaspora communities, there has been a huge outpouring of good will and monetary help. These people are highly motivated but to make their donations really effective, they should realize that they themselves need to go back to Pakistan for manageable periods of time, in order to set high ethical standards and teach the local management ways to make the funding more productive. What happens too often is that development and relief work becomes all about the relief organizations and providers themselves rather than about the people they are trying to help. Over time, many organizations seem to forget their primary purpose, which is help people.
After the floods it seemed as if most organizations and well-wishers focused entirely on donating as much as they could. But these efforts were totally disorganized. There was no coordination and funds were going to the wrong people. Organizations quickly spent money to show that they had done something so that they could get more funding. Our organization tries to be different and not fall into this mode of thinking. We hold conferences every day to stay on top of people’s needs and to make sure this remains our focus, to help them to stand on their own two feet. If we came across options to collaborate with other organizations that do not align well with our own core objectives, we decline participation.
I was the only American on the ground, working in villages with the local people, creating goodwill for America while do this. I told people that the only reason I was able to come back and help them was because of what I had learned in America. This breaks the stereotypical view of Americans and is a message that people in Pakistan need to get. With more people from the Pakistani Diaspora on the ground helping their communities, this effect would be tremendously magnified.
Right now, the focus needs to be on the most immediate needs; the need is so great that we just need to get these people on their own feet; it is not yet time to focus on peace-building. But it is one of my goals for the future and I truly believe in it. Because the religious leaders have a lot of clout in their community, if we don’t involve them then we are really missing out on a lot and I think that is the key to success.
If all organizations could work together with one mind, and coordinated for one purpose, then we could do better. We don’t want to do only short term projects because our goal is not to make people dependent on us but rather to help them to be self-sufficient. I work to set high ethical standards. We need to pick projects that will encourage people to be self-sufficient and decrease dependency.