‘Not a quitter’: The Karachi doctor taking rapists to court

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Warning: This article entails crucial functions about sexual abuse that some readers could well well perhaps additionally just web annoying.

Listen to this legend:

The toys on the desk are “ice-breakers” for the children, the doctor tells me. A beaded bracelet, a exiguous toy skull, chalky white dental moulds, a tumbler shaped like a lightbulb with a inexperienced sweet-striped straw.

When her son and daughter were youthful and would eat McDonalds’ Elated Meals, Dr Summaiya Syed would assign the toys from them and narrate them to work to add to the stash.

She would clutch dolls and hand them to a teenager sitting across from her in the successfully being heart room and play a game. The doll has been wound. “Can you demonstrate me the put it’s hurting?” she would demand. “Did someone touch the doll?”

If the youngster showed her the put it wound, the put the doll had felt an undesirable put, Dr Summaiya would demand, “Who did this to the doll?” There are no dolls right here at the brand new time. The kids retain them when they depart the successfully being heart.

Dr Summaiya has been a lady medico-upright officer (WMLO) for 23 years. The bespectacled 50-one year-passe doctor looks as if a kindly but company instructor. She has a warmth smile and she patiently answers questions, but when a customer asks her to tweak the principles slightly for some kinds he wants, she adamantly refuses.

On the day we meet, her hair is pulled help in a bun and she is wearing a casual orange and shadowy kameez with shadowy denims and sandals. Dupattas only web in the draw, she says.

The door to her dwelling of enterprise does no longer reside closed for lengthy, with employees popping in to bustle a resolution by her or give updates on a case. Some of them call her ‘Sir’. She answers their queries and picks up the thread of our dialog with out quit.

If I’m attempting forward to a lull to initiate asking my questions, I’ll be right here a whereas.

“We don’t quit for someone,” she says.

Toys on Dr Summaiya's desk
The “ice-breakers” for the children sit on Dr Summaiya’s desk [Sanam Maher/Al Jazeera]

‘The bowels of society’

In 1999, Dr Summaiya, new out of scientific college, was once posted at the police surgeon’s dwelling of enterprise at Karachi’s Civil Health facility, the put it was once her job to peek female victims of violence including rapes, assaults and unnatural deaths, akin to suicides, homicides or accidents.

On the moment, she says, they didn’t even spend the words “home violence”; it was once just called “physical assault”.

“I had no thought what I was once in for,” she remembers.

In scientific college, whereas her peers were in lucrative specialisations, she knowledgeable a friend she would need to be a coroner. And so it felt like a stroke of luck to her that she was once a 27-one year-passe with a stable government job at a public successfully being heart that paid 6,000 Pakistani rupees ($34) a month, tasked with figuring out the cases below which someone had misplaced their life or been injured.

Not every person conception that. It is a job the put you web your hands dirty.

“The MLO sits in the bowels of society,” Dr Summaiya explains. “I’ve viewed our bodies with heroin capsules of their abdomen, I’ve dealt with new-born children thrown on rubbish dumps, battered females, we poke to graveyards for exhumations, it will be valuable to address the police and poke to court to demonstrate your findings…” She trails off.

Quite so much of the doctors who had been inducted alongside with her, especially the females, requested transfers. In a city of roughly 10 million people at the time, there have been only four WMLOs and, as a ways as she can remember, 20 male MLOs.

In the main month of her new job, Dr Summaiya dealt with the case of a lady who had been raped by her sports instructor. She was once summoned to court – her first time there – to demonstrate her proof.

Even after all this time, she peaceful remembers the mediate’s establish and the court room number. “Jaffrey sahib in court room number one.”

When she was once grilled in spoiled-examination about why the girl’s hymen regarded to have escaped injury, she quoted from the MLO’s “holy book”, Parikh’s Simplified Textbook of Clinical Jurisprudence and Toxicology to demonstrate why she could well well perhaps additionally no longer conclusively snarl that it had, as she was once unable to peek the hymen clearly to match for injuries. “I knew that with children below the age of 10, the hymen cannot be with out grief visualised, and I knew exactly which page it talked about so in the textbook,” she says.

The mediate grew to become to her and talked about, “You’re in the just discipline.” The perpetrator was once sentenced to 14 years. It was once Dr Summaiya’s first conviction. She hasn’t regarded help since. “I thrive on this work,” she says.

A photo of Dr Summaiya behind her desk examining a piece of paper someone is holding in front of her.
Workers pop into Dr Summaiya’s dwelling of enterprise most continuously to demand a requirement or replace her on a case [Sanam Maher/Al Jazeera]

Every case is a puzzle

An MLO is accountable for conducting a full physical examination of a victim, collecting proof for attempting out, offering remedy (akin to emergency contraception in the case of rape), referring the case to the police and testifying in court if needed. An MLO can address victims of incidents akin to bombings, firearm injuries, physical assault, assassinate, suicide, rape and sexual assault. The MLO writes a memoir in step with their examination and files statements from living victims. Every are submitted to the police.

“I tried my hand at paediatrics, but I was once too emotional with my patients to be of any spend to them,” says Dr Summaiya. Even now, she is greatly troubled when she has to peek the our bodies of children or pregnant females who’ve suffered violence.

“I will take into consideration the agony they were in of their final moments,” she says. “It’s a curse. I had to learn to compartmentalise and no longer lose my objectivity.”

Dr Summaiya is motivated by the likelihood of an investigation. “I cannot sit peaceful till a case is solved.”

Every case, she says, is like a puzzle, one which requires no longer just a terminate view of the textbooks, but proper instincts. In a single case, as an instance, a lady was once brought in by her father as he talked about she had been raped by their neighbour. “I felt suspicious about why the mother was once no longer with the youngster at this demanding time,” Dr Summaiya explains. She requested for the daddy’s blood sample.

The cells from the girl’s vaginal swabs matched with the daddy’s blood sample. He had lied about the neighbour to veil up for sexually assaulting his youngster. “These puzzles don’t narrate me down, they wake me up,” she says.

After I demand the put she developed a style for thriller, she laughs. “Who’s aware of! Agatha Christie books? A hearty dose of Famous 5? Perchance Nancy Drew or jasoosi (perceive) novels.”

A photo of Dr Summaiya with a whiteboard with some writing on it behind her.
On a whiteboard, Dr Summaiya has written a pair of key proverbs as a reminder [Sanam Maher/Al Jazeera]

‘Not a normal mother’

There’ll not be the form of thing as a satisfaction, on the other hand, in some cases. In Could perhaps well 2020, when a plane crashed in a residential neighbourhood in Karachi, killing 97 passengers, Dr Summaiya did 34 autopsies in in some unspecified time in the future.

And in this city, the put every person has a legend about a mugging long previous awry or can show you exactly the put they were when a rebel broke out, it didn’t steal lengthy for a well-recognized face to come on a gurney in her examination room. In a single case, the body of a 16-one year-passe lady who had been stabbed by a dwelling intruder was once brought in. She was once a friend’s daughter. “I misplaced depend of the wounds,” Dr Summaiya remembers quietly.

Three years into her first job, Dr Summaiya’s son was once born. When he was once no longer even a one year passe, she would narrate him in to work alongside with her when she was once on evening duty. “You’re on call 12 hours a day, without a days off for Eid, no in sorrowful health depart, no days off for a loss of life in the household,” she says.

Her son was once discovering out to inch, peaceful wobbly on his legs, as she would sit at her desk and write her notes from examinations. The violence she witnessed indelibly seeped into her journey as a mother. By the point her daughter was once born in 2004, she says, “I was once a traumatised mother, no longer a normal mother.”

While her children, now 18 and 20, shaggy dog legend that they’re ‘prisoners’ due to her principles (curfews, no utilizing motorbikes, all mates must be presented to her), she explains, “Here’s what I knew even earlier than they were born: at even six months, a teenager will even be raped. At 10, they are going to even be kidnapped.”

When her son went to a concert on Valentine’s Day this one year, she called him terminate to his 10pm curfew. He didn’t resolution the phone. The concert was once in a basement venue and he had no cell reception there. “For an hour, I was once going loopy with fear,” she says. “I ended short of calling the police in that neighbourhood’s jurisdiction to raid the venue.”

A photo of a sign with a list of names of additional police surgeons
In November 2020, Dr Summaiya grew to become the Additional Police Surgeon, Karachi at Jinnah Postgraduate Clinical Centre. She is the main lady to help this submit [Sanam Maher/Al Jazeera]

Altering the gadget

In November 2020, she started a brand new characteristic, becoming the main lady to help the submit of Additional Police Surgeon, Karachi, at Jinnah Postgraduate Clinical Centre (JPMC), one amongst the city’s busiest public hospitals. “I was once posted right here by some other people that conception I could well well perhaps additionally narrate about a exchange in the gadget,” she explains. “My colleagues and I needed to execute this successfully being heart the face of medico-upright requirements in the nation.”

Amongst the reforms on her agenda: the need for bigger dialogue on ‘object rape’, introducing traditional working procedures for the sequence of samples for proof, and no MLO working below her would be allowed to spend the ‘two-finger take a look at’ on rape victims.

Dr Summaiya describes the latter, whereby a doctor inserts two fingers into the vagina to detect if the hymen is demonstrate and the blueprint “habituated” a lady is to intercourse, as “equivalent to raping a survivor again”. Many MLOs, she says, persist in utilizing the take a look at in dwelling of ticket bruising or injuries or talking with the survivor to uncover what has came about as they feel it’s “faster and more uncomplicated”, and most continuously don’t bother to steal vaginal swabs or assorted samples when they’ve performed the take a look at.

In 2021, the Lahore Excessive Court banned the take a look at in Punjab province, pronouncing it was once “illegal and against the Constitution of Pakistan”; Dr Summaiya and a senior doctor, Dr Farhat Hussain Mirza, were tasked by the successfully being division with supporting a petition calling for the take a look at’s abolition in Sindh province, and the court ruled of their favour in September 2021.

“Now we have been working at nighttime ages for thus lengthy, and that is why our judicial gadget is the draw that it’s,” Dr Summaiya says. She draws a triangle for me on a bit of paper. She writes at each point: MLO, prosecution, investigating officer. In the centre of the triangle, “mediate”.

Every point needs to work collectively on a case for a a success conviction, she explains. In the case of sexual assault, a cursory peep at the numbers tells you that right here’s no longer going down: more than 14,000 females have reportedly been raped in Pakistan in the final four years, and fewer than three percent of rapists in these cases were convicted.

A photo of Dr Summaiya sitting outside the room where female patients/victims are taken to be examined, sitting on a bench and looking at her phone.
Dr Summaiya sits open air the room the put female patients and victims are examined [Sanam Maher/Al Jazeera]

Evidence for a watertight case

In her nook of the triangle, one amongst the changes that Dr Summaiya has been engaged on since 2016 is an overhaul of the draw that proof of sexual assault is documented.

She hands me a make with a pair of sections to be crammed in. When she first started working, right here’s the more or less make she would be required to spend to gain proof. With journey, an MLO would learn that this make contains a bit of the ideas wanted for a watertight case. “A doctor would beget this make in step with their abilities,” she explains. “A colossal deal was once left to likelihood as a doctor with a day’s journey will memoir proof very otherwise to a doctor who has 20 years of journey.”

That piece of paper is a most notable memoir. In 2002, in one amongst potentially the most successfully-identified cases of rape in Pakistan, 14 men in the village of Meerwala in Muzaffargarh district, Punjab, were accused of raping a lady named Mukhtara Mai as revenge for her 13-one year-passe brother’s alleged relationship with a lady from one other tribe. She was once then paraded bare thru the village. Most effective six of the 14 men were convicted and sentenced to loss of life. They appealed and 5 were acquitted. In 2005, the Supreme Court upheld this judgement by the Lahore Excessive Court, citing an absence of proof.

Dr Summaiya does no longer need something to dart thru the cracks. She locations a 2nd make on the table. It is more detailed, with three sections documenting a physical examination, the doctor’s notes and conception. “Ogle at this one,” she instructs. “Even if it was once your first day on the job, the make guides you. With this, we attain no longer need to rely on a doctor’s journey to match unnecessary to claim things.”

Shall we snarl: Has the victim bathed, due to this fact inserting off doubtless proof? Does the victim have children and in that case, what was once the mode of supply? “A girl who has had four children will demonstrate otherwise when put next with a 14-one year-passe,” Dr Summaiya explains. “If she has fewer injuries, that does no longer mean she wasn’t subjected to rape.”

The new make asks the doctors to mention the victim’s gait. If a lady has been gang-raped, her gait is affected. A doctor need to ticket down the dates of the incident, the victim’s restoration and the date and time they were examined. With the passing of on a normal foundation, an MLO’s findings will exchange as proof – traces of semen, blood, or marks of violence – will even be misplaced.

“With the total extra files, I’m giving the police and prosecution proof to fabricate a case, to corroborate what the victim tells them,” Dr Summaiya says. The new make has twice the draw to ticket down “marks of violence”, so a doctor will even be as thorough as imaginable.

A form used at Jinnah Postgraduate Medical Centre to assess possible rape cases
The new make to doc cases of sexual assault that was once presented by Dr Summaiya at Jinnah Postgraduate Clinical Centre, has been designed so that no proof slips thru the cracks [Sanam Maher/Al Jazeera]

Resistance in her poke

A kitten mewls from below her chair. Dr Summaiya has forgotten to feed the litter of strays open air her dwelling of enterprise. “Come on, infant,” she says, getting up. One other kitten darts out from a nook. “The cats we steal care of attain have names but right here’s a brand new bunch, so for now their names are billi (cat) no 1, 2, 3, 4 and 5.”

When she returns, one amongst her clerks brings in a plate and she beams. Masala-lined French fries. He conception she could well well perhaps additionally just be getting hungry. She continues to demonstrate the crucial functions on the brand new kinds to me whereas nibbling on the fries. Nevertheless then one other member of her employees walks in and scolds her. “Your blood stress is going to be excessive in case you eat these.”

She ignores him and continues. “After I first started working, we did no longer need to memoir the victim’s consent to be examined,” she says. “Ought to you forcefully examined someone who has been raped, what’s the distinction between you and the rapist?”

The types were submitted for approval to the prosecutor traditional and to boot they’ve been in spend at JPMC for a one year. Dr Summaiya describes them as an evolving doc and she hopes that they are going to at final be vulnerable across Sindh. She asks her MLOs – four females and three men – for feedback and plans to tweak them additional, with the addition of sections akin to pictograms to thoroughly doc marks of violence on the body.

Nevertheless the exchange has no longer come with out grief.

To the left of her desk is a exiguous whiteboard mounted on the wall with the following instructions: “Terminate ready for honesty from other people that deceive themselves. Keep your explanations for people that brand you. Give your silence to people which would possibly make certain you misunderstand you.”

Dr Summaiya has glanced at this whiteboard most continuously in the previous one year. She retains a yellow and inexperienced rubber snake on her desk, to remind her of her enemies, she says, only half of-joking.

There was once resistance to the brand new kinds. While some MLOs talked about it was once no longer their job to gain extra files and it took too much additional time, others knew that it hampered their possibilities of fudging files, misreporting it or leaving out files in exchange for a bribe from the perpetrators.

The make shows sorrowful remedy: as an instance, an MLO is now required to ticket the time a victim was once brought in and the time they were examined. “If there is a hole of several hours, the MLO gets caught, you peek, and to boot they’re no longer joyful about it,” Dr Summaiya says. The quantities slipped below the table can greatly supplement a meagre government salary. In a single case, Dr Summaiya says she was once provided – and refused – 2.5 million Pakistani rupees ($14,000) to memoir a assassinate as an accident.

She has realized to steal the resistance in her poke. The hurdles are no longer new.

A photo of a toy snake on a desk.
Dr Summaiya retains a toy snake on her desk to, as she explains half of-joking, remind her of her critics. All the blueprint thru conferences, when she’s going thru files or chatting alongside with her clerk, the snake sits on her desk [Sanam Maher/Al Jazeera]

‘Stepchildren of the scientific gadget’

The dwelling of enterprise distributed to her is positioned in the successfully being heart’s passe surgical hover. Old indicators for the thyroid sanatorium and examination rooms reside on the doors. Files are weighted down on stretchers and three clerks have devised a gadget to retain them organised. Outside the dwelling of enterprise doors, men hasten their motorbikes thru the corridor and paan stains walls plastered with notices to recognize the successfully being heart draw and retain it clear. The dwelling of enterprise we sit in has no air conditioner, no neat windows for ventilation. It will be brutal in the summertime heatwaves.

Dr Summaiya has been in this room for six months, as her final dwelling of enterprise, just across the corridor, grew to become unusable when piece of the ceiling crumbled and caved in. It’s now filled with sacks of passe files destroyed by water anguish or termites. Some of these bags could well well perhaps additionally just possess reports wanted in court, as cases can steal six months to four years to head to trial. The final time Dr Summaiya was once in court this one year, it was once for a case she documented in 2016.

On on daily foundation foundation, people come right here on one amongst the worst days of their life and to boot they’re at the mercy of a gadget that appears to be like designed to fail. There’ll not be the form of thing as a payment range for the types that doc the violence they’ve continued – every month, the MLOs make a contribution Rs1,000 ($5.60) each to pay for the printing of kinds, and Dr Summaiya makes up the deficit.

This one year, the Correct Support Society, a no longer-for-earnings organisation offering assistance and illustration, provided the funds. The victims will be examined in a room with blinds that Dr Summaiya paid for to ensure their privacy, with bilingual posters she had printed to divulge them of their rights. A victim depends on the MLO to gain as much proof as imaginable, but what they would well perhaps additionally just no longer know is that the MLO could well well perhaps additionally just be required to comprehend swabs, jars, or sterile casings for samples out of their very beget pocket if affords drop short. “Ought to you don’t steal on the associated rate, you’re weakening the case,” Dr Summaiya explains. “In court, it’s no longer proper ample to claim that you didn’t attain your job well on fable of you didn’t have what you wanted.”

Ambulance drivers share clear sheets from their affords to veil our bodies, E.R. employees present sanitiser, PPE or gloves. Once samples are nonetheless, a police officer will transport them to the lab, most continuously travelling on a motorcycle. In a single instance, an officer carrying glass vials of samples in plastic bags bought into an accident. All proof was once destroyed. “We’re the stepchildren of the scientific gadget,” Dr Summaiya says with a smile. “No one is engrossing to accept us or present for us.”

There could be little hobby, she says, in how most notable their work is. Most doctors push apart the MLOs as a immoral bunch. “Our recognition precedes us, and the few who aren’t dishonest are tarred with the identical brush,” Dr Summaiya explains. “In spite of all the pieces, you don’t eat the total deg (pot) to mediate the biryani, attain you? You immoral your conception on one chew.”

After I demand her if she ever thinks of quitting, she laughs. “On on daily foundation foundation! On on daily foundation foundation I show my husband, ‘That’s it, I’m completed, I’m no longer coming into into tomorrow.’ And he jogs my memory, ‘That’s what you talked about the day old to this.’”

She pulls the rubber snake on her desk closer and strokes its webbed sample. “It is a fight that continues, and if I quit, I’ve misplaced. I’m no longer a quitter.”

In Pakistan, the hotlines for gender-basically based harassment or violence are 1043 (toll-free; Punjab Commission on the Space of Ladies people; 1098 (toll-free), 0311-6641098 or e-mail madadgaar@cyber.receive.pk (Madadgaar); or 0800-13518 (toll-free; Sahil).

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