Flitting through time 1918/2020: A study on women and pandemics in the subcontinent.

By Noor Fatima Bokhari

“…we must concede the fundamental liminality of the archive: its porousness, its permeability, and the messiness of all history that is made by and from it.” – Antoinette Burton

Introduction

The history of the 1918 pandemic although full of singular stories, is a shared history of the subcontinent. Each piece of the past allows for transportation into a complex and compelling world, previously unvisited. South Asian archives, however, are spaces that reveal much more than what they simply preserve. They measure the length of distance across our borders. The many conversations frozen mid-way only waiting to be picked up again. But most importantly, voices that have echoed across generations yearning to be heard and known. A document is found and one must ask: what life lives in it? In answering this, one also wonders why this life seems incomplete. This is an almost natural inquiry when the archive is so obviously male-patterned.

The primary finding of this project has been that there is silence in the archive. In the sense that, one must continuously question loudly to find direction. The researcher must look for some reciprocation, in the hopes that this silence is broken, and a response garnered. In this case, I have had to venture outside of the archive as well. Initially, as I set out to discover how women had been represented between 1918 and 1920, I found that there was barely any sign of them. The question that I posed initially asked: How are women, who are often cast aside as having little power, being viewed with the strength to protect others during a pandemic? This question comes from what is an impatience and curiosity for today. When one takes on history and tries to ask the same question, it cannot be answered. It must be reworked so as to recognize the way in which the past is in alteration from the present. It then becomes: are women being viewed at all? With this, I have also been able to form some conclusions about how an archive functions. Given the limitations of this research project, I was able to access three among, what must be, hundreds of South Asian publications for my exploration. This includes The Bombay Chronicle, The Searchlight and The Times of India. In addition to these, I have also consulted with periodicals and academic books pertaining to that time period. I would also like to acknowledge the generous guidance of Dr. Ali Raza, Dr. Ali Usman Qasmi and Dr. Nida Kirmani. Additionally, for simplicity, the paper refers to Pakistan only when discussing the present.

For clarity, this paper visits the past and present alternatively, in many phases. This is because both come alive only when they speak, as they have always spoken, to one another.

Past: Understanding the Landscape of 1918

Fig.1. The Searchlight, 11 August 1918

Fig.2.The Bombay Chronicle, 26 September 1918

Fig.3. The Searchlight, October 1918

18 million: this is the approximate number of people who died of influenza in British India. 6 percent of the entire population was lost. And according to statistics, more women died than men. In that, the number of deaths across different genders was disproportionate to a large degree. With this, colonialism was a companion to the disease. Denial of the outbreak and its deadliness was practiced most frequently by the colonial officers. There were also already existing “social and historical processes” driving the spread of disease. One of the most prominent amongst these was the imperial food system, established long before the virus hit. The drought of 1918 occurred due to a failed monsoon, but proved devastating because of the colonial government. Ultimately, a food crisis also engulfed the region, leading to greater vulnerability to disease. The newspapers also reveal that the First World War was of utmost importance. One of the reasons why human health mattered was because it strengthened the Army (Fig.1.). This is where one meaning for survival seemed to be stemming from most profoundly. It had little to do with the basic acceptance of all life being worthy and valuable. The colonial desire for wealth did not waver even under the specter of a disease that touched all of humanity. That was, quite literally, the blinding power it held.

Bombay was hit by the pandemic in June. From there the infection spread, meandering its way into cities both near and far. Initially, there was confusion around what the illness exactly was and how it was to be avoided (Fig.2.). Many pharmaceutical companies regarded it as a flu that could be easily. Various columnists coined it as “war fever”. Local indigenous medicine producers saw it as faceable and palmists and hypnotists seemed even more optimistic. Some of these advertisements, as the pictures suggest, could be seen as merely trying to capitalize on worry and panic (Fig.3.). However, there is much else to understand as well. For one thing, there is a distinct difference in the advertisements directed towards men and women. We see that theories around masculinity, femininity and hygiene all inter-mix to produce specific cultural messages, which in turn, influence how women are oriented and understood in society.

According to historian Manan Ahmed, we live in a “post-colonized” world rather than a “post-colonial” one. This is precisely what this project believes in. Therefore, the study of women, no matter within what niche topic, cannot be done in isolation from the umbrella influence of colonialism. In addition to the individualized selves they make up, they were and still are in many ways also colonial subjects. Both histories continue to collide, reshaping the assumptions and findings of this paper.

Fig.4. The Searchlight, 15 September 1918

Fig.5. The Searchlight, 16 February 1918

Present: Nudging gender roles into new realms

Fig.6. Dettol Pakistan, Facebook, 10 May 2020

Fearing life and longing to live it: this is one way to define the coronavirus pandemic. It is a common occurrence in times of danger to borrow from the bravery and patience of others. This dynamic, however, changes when we turn towards female caregivers. It morphs into something entirely new within the context of a life and death situation. This care provided by women becomes compounded with a hopefulness and comfort not found very easily elsewhere. So much that, women are often drained of it. Today we see it convulse with cultural expectations and norms as well. The women must preserve the health of the family, child and husband. This is the story various advertisements including the one by Dettol tend to tell.

The world at large has become harsher, but the already harsh worlds of women camouflage against this onset. Everything has changed, but nothing has changed. Adding onto her domestic duties, she is now meant to battle it out against a pandemic. This means shelving off everything else to pay attention to all the necessary precautions. Taking up the feeling of concern as a perpetual state of mind. The gravity of this feeling will obviously vary, and my analysis cannot speak about the real experiences women face. However, depictions of women matter, precisely because they shape not only how women are seen from the locus of an outsider, but how she sees herself as well. The danger lies in the resultant formation of an unquestioning society. One where these messages fit neatly into the commonsensical, leaving no room to think differently. All that remains is a passive digestion of a flawed representation as something that is necessary, urgent and essential.

Children, although an accessory to women in these advertisements, are also buffers. The hygiene of a woman must be a service. Otherwise, it affords her agency that is in excess. Which then becomes unacceptable to the systems that weave together this society. Protection for herself needs relevancy that is greater than the value her life holds in itself. That is, her safety is not a right, but something she owes to those around her. This is a gender role, but when disease joins hands with it, it becomes something inescapable and justifiable. It becomes difficult to dispute because of how much depends on it: the lives of other people.

Past: Influenza and its binaries

Fig.7. The Searchlight, 5 September 1918

Fig.8. The Searchlight, 9 January 1918

In this battlefield of disease, who is fighting and how is the fighting being done? According to older advertisements it seems that the pandemic is a wrestle between heroic male figures and illness. These figures are in constant need of rejuvenation and in a frenzy to reclaim “Herculean strength” (Fig.8.). There is a gendered description of who is falling victim to this disease then. The language must be paid attention to closely. It helps to create a warrior-like character almost, that is trying to resist the withering away of its physical strengths. There is honor and dignity attached to this representation. With this, there is also an entire perception of sickness coming together. It is almost as if the threat to masculinity is bigger than the threat to human life. Most of all, it describes what it takes to tackle an epidemic and who is at the center of dealing with it. This is pertinent to my research because this depiction helps to piece together the assumptions that are in parallel, being made about women. Their absence from these newspapers, and not just the advertisements, makes them seem untouched by the times. Almost as though they were immune to the challenges that came with the spread of disease.

If one was not a victim to the pandemic, besides immunity, the next most plausible reason was invisibility. This government notice (Fig.7.) outlines briefly who the “Victims to Influenza” were. Ultimately then, this small section points towards the lives that are worth mourning. In fact, the few obituaries that dot these newspapers have made no mention of female deaths. This is in light of the fact that women, experienced higher rates of death than any other social group. It is true that the colonial administration “turned exclusively to men when they established local political offices.” That perhaps, publications like these could only report deaths that were knowable. This, however, cannot discount the messaging that is left behind. To mark a death publicly it seems, means that the life lost must have had to take up distinct space in the public. Here, we see one mention of a wife also. But that is all. She is an association. Beyond this, nothing seems to be known about her. Let alone her name. These deaths, specifically of the men, then constitute what is a public graveyard. That is, one that only memorializes the bodies of men. In doing so, we see that women have not only been written out of a diseased community as they actively exist in it, but also long after they have left the world, the colony and the home.

Fig.9. The Searchlight, 27 October 1918

Fig.10. The Times of India, 9 October 1918

While carrying out this research, I found that it is in the available that the unavailable is realized. These advertisements cannot attest to the lives of Indian women in a direct way. Yet, they remain crucial in deepening the knowledge around the watermarks of stories faintly visible. It helps, if one pays attention to the language. The patient is a “he” and the cure brings back “manly” spirit (Fig.9. and Fig.10.). The safety women provide is of a secondary nature. It seems that masculinity makes protection glamorous. If women are harnessing any strength to fight disease, it is in private. It is an ordinary endeavor involving children and the domestic space, and hence one that is not lauded as heroic or exemplary. This also makes one ponder about the need to make cleanliness a heroic act, when it is so blatantly human. This excerpt from a periodical called Ismat, provides reason to make this claim (Fig.12.). In the archive, materials of this kind are seen as supplementary rather than as essential; something that reveals much about the biasness of history.

In one way this also indicates how life is understood in colonial India. One which is the public, and is living with vibrancy, and one that is the private, is breathing, but behind closed doors. This demarcation between the public and the private/domestic becomes apparent through these advertisements. But what is important here is that, both make up the history, even if the archival materials suggest otherwise. Additionally, despite being colonized subjects, men, unlike women were differently positioned elites. In that, even though there was pressure associated with this conception of masculinity, it did not entirely reach the breaking point. This, although a separate topic from the one I am exploring, tends to influence my findings. In the sense that, the possession of masculinity accentuated ones effort, resistance and forbearance. It was loud enough, so much

that it glossed over the quiet but equally powerful work of women towards protection and care. If women were pictured on the battlefield even slightly, they were only wreaking havoc. One mode of work, and perhaps also the most popular in the field of medicine for women, was that of midwifery. Lingering on since the nineteenth century, women involved in this profession were given a caste. They were most commonly referred to as “dhais”. A Public Health Commissioner Report of 1920 reveals that the colonial officer held great disdain for them. This aligns with the long held belief of “Western missionaries and social reformers” coming to India to educate these Indian women on the basis of a “moral duty to uplift, sanitize and modernize traditional societies”.

Fig.11. Public Health Report India 1920

Fig.12. Ismat Magazine, March (1910-1918)

Fig.13. The Searchlight, 1 September 1918

Female medical education was concerned mostly with “sanitation and cleanliness”. It is interesting to note that women received formal education when it came to hygiene, but even despite this were not celebrated for their knowledge, like the men were for their perseverance. The mid-wives have also been labeled as the proponents of the high mortality rate (Fig.11.). In doing so, mortality has been explained away as the responsibility of not only local people, but specifically women. The reasons for it, however, go far beyond this, to include, the outcomes produced by the British themselves. As mentioned earlier one such example is that of food insecurity. Unlike the present then, the past reveals that women were caricatured as aloof and unaware of the seriousness that comes with disease. This indigenous medicine being practiced by women becomes a laughing stock for the white rational world of cure.

What we see here is the construction of a clear and well defined binary. This is not to say that distinctions between men and women did not exist prior to this time, or even to colonialism. It is the hierarchical nature of it that has been emboldened within such a context. There is safety where there is masculine power and strength. And there is lack of purpose, intelligence and leadership where there are women. This also does not discount that local men were given definitions of uncleanliness or pushed towards impossible standards of manliness. It is just that within the context of a pandemic, the most important and prominent materials of historical analysis I have found create a subcontinent where the discourses around disease were driven by this divide. And therefore this is the assumption my research project tends to draw with most clarity. It does not aim to dismiss any other experiences related to hygiene (and its construction) in the region.

Fig.14. Ismat Magazine, October 1918

Present: Super-heroes versus the domestic sphere

A research project cannot speculate about what makes a woman feel visible. This is a feeling each woman decides for herself. It is beyond the calculation of this analysis. However, when analyzing the advertisements of today, there is one consistency. The woman is always placed within the landscape of a family unit; a house. At first glance nothing stands out in this picture (Fig.15.). This is a slogan that makes the rounds frequently, only with different models and placements. On second glance, there is an oddity to it. There is a very specific

Fig.15. Dettol Pakistan, 2020

arrangement being made in this picture. This could have easily been a soap advertisement including a father or a husband. After all, is that not the typical family ideal? This is the realm where women are given representation most easily and generously. Why is this? There seems to be an obsession with linking cleanliness to them. When looking more closely, there is also the suggestion that only one kind of woman can possess this hygiene. As if this knowledge to remain clean comes through the experience of motherhood. She must be encompassed within a home environment, her maternal instinct the primary driver for valuing health. The ability to practice precautions it seems can only be possessed through —not by being a human being with a reactionary response to disease—but by being lodged within a very specific living context.

One of the counter arguments to this claim could be that these advertisements are simply trying to “provide messages that are maximally effective to their relevant target audience.” That it is nothing more than an innocent marketing strategy and a prompt for inspiration. More so, that they convey a sense of agency and independence in relation to women. Almost as though a woman can be this super-hero, not needing anyone’s help. With this perspective, no one seems to be losing out. Even if this is true, what is left in the wake of such a depiction is the central interest of this project. This kind of logic, presented in such a quick way, with little explanation or nuance can become a breeding ground for unfair conceptions of women.

In this image, we see the irony of power again. The final victory secured through the soap is not only one of “germ-free protection” but also of great joy and satisfaction. She has provided for her family in an emotional way also. Something already expected of her, now has another means with which to be attained and presented. This is more than what one would call caretaking. This is sacrifice. The universal threat of a disease has developed a careful character. It is something that has a weakness for domesticity and the guardedness of women. Protection then comes at the cost of raising the burdens of one body alone; the female body. These messages make time stagger. They put a halt to our otherwise fluid understandings of who we are. Today, they fit into our society as harmless messages. But the shadows being cast by them are perpetual, important and dangerously unapparent.

Fig.16. Safeguard Pakistan, 2020

“Commander Safeguard” is the face of Safeguard soaps in Pakistan. Most advertisements show him conquering battles against his biggest enemies: villain-like characters who encourage uncleanliness. With a super-hero of this sort, hygiene becomes not only more desirable by children but a means to achieve, what one could call, a kind of power. In one way, this power is embedded deeply within the notions of masculinity. Women, as seen in earlier depictions, are to be the flag-bearers of hygiene. Yet, here, we see a typical male figure infusing into this role. It seems that this linkage of cleanliness is not one influenced by gender alone. But more so by the idea of gender roles on either side of the gender-binary. This safe haven of comfort and care can exist at both ends. And unlike the advertisements of the past, both men and women are exalted in these roles, even if in profoundly different ways.

It also reveals how gender roles are manipulated to not only boost multinational businesses but to also ensure obedience to a rule. It is convenient to morph masculinity as “Commander Safeguard” to propagate the washing of ones hands. There is a double reward. The lather promises not only protection but the seizure of a certain kind of manhood; a feeling of responsibility that is deeply tied to a gendered narrative. What is most interesting however, is that this kind of knowledge production is not only food for adults. It also proves to be feeding younger minds, and hence, has the potential to clog up the free-flowing river of thought far earlier than one would anticipate. There is indeed playful imaginativeness in looking up to characters like the Commander. But as reiterated before, it is the after-math, the settling down of these ideas as concrete theories that must be acknowledged. That is, these conceptions of the world, of the body, of identity, translate into limited world-views. And hence, limited people, with limited understandings of their true powers as whole and acceptable human beings. A pandemic makes an alternative harder to see. This is, then, the consequence that has driven my research.

Past: Magic, of all kinds

The concept of weakness due to influenza was intertwined with the long-held colonial metric that labeled indigenous people as frail and inferior. This, although an obvious assumption under colonized rule became something novel in the context of a pandemic. In other words, out of it came the birth of a new means with which to measure life. I have been able to claim this using this advertisement for “Dongre’s Balmarit” tonic. It proposes that three Indian lives are worth one British life. In all the newspapers available, this was amongst one of the few illustrations of what appears to be, given her attire, a South Asian woman. The most interesting thing however is that she

Fig.17. Ismat Magazine 1910

Fig.18. The Bombay Chronicle, 14 August 1918

is standing at the center of two weights. She is tipping the balance towards the healthier looking child. This is an important image then. It gives great insight into the idea of healing. To heal, the weak or ill did not mean a reversal towards a better version of who they were. Instead, the healing process moved in the forward direction, transforming the “weak” into an entirely different person. To be more specific, into an angelic, white body.

Fig.19. The Searchlight, 24 April 1919

Fig.20. The Bombay Chronicle, 15 June 1918

Power can have many shapes. It is almost transient because of the nature in which it is not only passed on but possessed. In this advertisement (Fig.18.), there is the suggestion of a power that can create and legitimize magic. That is, the mixture of motherhood and medicinal tonic can produce an otherworldly transformation of weakness strength. One could even call it a miracle. This goes above the notion of a safe-haven; it is guaranteed insulation from the will of disease. Other archival records reveal that this “magical” quality of women was not only one that came up in conversations around care-taking. It was something that was very wholly associated with Indian women. This advertisement for “Kaminia Oil” (Fig.19.) shows, again, a distinctly Indian woman—with long thick hair and a traditional bindi on her forehead. She is advocating for this product because it helps attain “lustrous” hair “as if by magic”. This kind of depiction has only been linked to Indian women in the material I have acquired. Since the connection of this “magic-like” attribute is not only to disease but also beautification, this perception of women seems to be stemming from a time earlier than 1918. Only that in the midst of a pandemic, it helps to emphasize other cultural and gender expectations in a less suspecting way.

This ad for “Erasmic Soaps” (Fig.20.) for example, although published during the initial stages of the pandemic is indicative of the expectations demanded of women. The illustration of the European woman suggests a concept of cleanliness as it associates strongly with whiteness. Here is an instance of power at play, where it is seen in action, where it really awakens. Power is interesting because it first makes the South Asian woman believe she can be who she is not. That she is so powerful, she can defy the permanence of her already existing self. In this thought alone, she has all the while been made equally powerless. That is, she is being distracted from recognizing the liberation that lies in embracement. These advertisements also provide a purpose for practicing hygiene. For the woman, the primary reason is not to preserve her life, but her “purity” and “beauty”. There is meaning to the female life only when it is perfumed to smell a certain way.

This idea of health having a face, a color and a specific demeanor was not only found in advertisements. It was, it seems, part of conversations within the communities of Indian (more accurately Muslim) women as well. This section titled and translated as “Methods with which to keep health and color well” (Fig.21.) has many commonalities with the “Erasmic” soap. Only that, it is in Urdu, which indicates that this sentiment is accepted while also being imposed. In other words, this is something indigenous thinking supported to some degree. This excerpt is from a women’s periodical based in Delhi called Ismat. From the kinds of articles it published, it is clear that the readers did not only consist of women. Some of them, at least in their tone and writing style were directed towards men as well. Hence, it would be safe to assume that the content it published was being absorbed by more than just a female audience. There are limitations associated with using such a source for inference, but it can still help enrich ones understanding of the lives women led at the time. These beauty standards, then, were ones that lived inwards as well, with a willingness. Conclusively, cleanliness in relation to the woman was not a feeling but an image, a look, and an attitude of being.

Fig.21. Ismat Magazine 1910

Conclusion: The time-space between then and now

After the pandemic ended in 1920, something must have happened to have caused both such drastic differences and similarities in how we view women today. At the time, a frenzy for nationalism hung in the air. In fact, it was further emphasized by the many grievances associated with influenza. The death-toll kept rising without reprieve. Various social movements demanding for independence, for example the Swadeshi movement that called for a purchase of only locally produced products, were gaining momentum too. This was also the beginning of a civil disobedience campaign. The years that followed included a hasty departure by the British and communal bloodshed of 1947. The split that still wounds the subcontinent cannot erase the very similar systems of patriarchy on either side. The question this project initially asked, to some degree then, has been answered. Women are seen as safe-havens but for things that the rest of society deems unworthy of its attention. This includes tending to children, the home and providing a comforting presence. As long as women are in charge of these, everyone is safe from the burdens that should be shared. Here is the safety, a safety that makes her agency so unsafe. Although this paper sees the present in Pakistan, it is crucial to remember that India throbs with the same societal expectations. This claim does not need much proof, simply because of the imprint of history binding the two together. It is difficult and perhaps also beyond the scope of this paper to find one clean thread that connects then and now. Yet, in this tunnel of time, that has watched the years drive by, the lingering whispers of newspapers, periodicals and books help make some understanding possible. It is the hope of this paper that the discussions it could not begin be begun by the reader. Any loose ends hanging, are prompts for further research and exploration. Much remains unwritten about disease, healing and safety in South Asia. Let this project be not an attempt at conclusiveness but an indication of all that is unsaid and must be proclaimed.

Foot Notes

¹Antoinette Burton, Dwelling in the archive: Women writing house, home and history in late colonial India (New York: Oxford University Press, 2003), 26.

²Soutik Biswas, “Coronavirus: What India can learn from the deadly 1918 flu.” BBC, March 18, 2020, https://www.bbc.com/news/world-asia-india-51904019#:~:text=The%20influenza%20killed%20between%2017,the%20sick%20%2D%20died%20than%20men

³Robert Farley, “Remembering the Spanish Flu in Asia.” The Diplomat, March 25, 2020, https://thediplomat.com/2020/03/remembering-the-spanish-flu-in-asia/

⁴Kasim Tirmizey, “Pandemics and Hunger: Lessons from the 1918 Pandemic in India.” Jamhoor, May 23, 2020, https://www.jamhoor.org/read/2020/5/23/pandemics-and-hunger-lessons-from-the-1918-pandemic-in-india

⁵Manan Ahmed, Manan Ahmed and Niab Mian, interview by Niab Mian. Youtube, SAAG Anthology, September 1, 2020. Video, 12:40. https://youtu.be/R4nM2A4kQ88.

⁶Kathlein Sheldon, “Women and Colonialism”, Oxford Bibliographies, 10.1093/OBO/9780199846733-0067.

⁷Tim Allender, Learning femininity in colonial India: 1820-1932, (Manchester University Press, 2016), 4.

⁸Ibid.

⁹Gad Saad, “Applying Evolutionary Psychology in Understanding the Representation of Women in Advertisements,” Psychology and Marketing, no.22. (August 2004).

References

Fig.1. The Searchlight, 11 August 1918. Center for Research Libraries Online Catalog.

Fig.2. The Bombay Chronicle, 26 September 1918. Internet Archive.

Fig.3. The Searchlight, October 1918. Center for Research Libraries Online Catalog.

Fig.4. The Searchlight, 15 September 1918. Center for Research Libraries Online Catalog.

Fig.5. The Searchlight, 16 September 1918. Center for Research Libraries Online Catalog.

Fig.6. Dettol Pakistan, 10 May 2020. Facebook.

Fig.7. The Searchlight, 5 September 1918. Center for Research Libraries Online Catalog.

Fig.8. The Searchlight, 9 January 1919. Center for Research Libraries Online Catalog.

Fig.9. The Searchlight, 27 October 1918. Center for Research Libraries Online Catalog.

Fig.10. The Times of India, 9 October 1918. ProQuest.

Fig.11. Public Health Commissioner with the government of India, Annual Report 1920.

Fig.12. Ismat, March (1910-1918). British Library Endangered Archives Program.

Fig.13. The Searchlight, 1 September 1918. Center for Research Libraries Online Catalog.

Fig.14. Ismat, October 1918. Rekhta.

Fig.15. Dettol Pakistan, 2020. Facebook.

Fig.16. Safeguard Pakistan 2020. Facebook.

Fig.17. Ismat, 1910. British Library Endangered Archives Program.

Fig.18. The Bombay Chronicle, 14 August 1918. Internet Archive.

Fig.19. The Searchlight, 24 April 1919. Center for Research Libraries Online Catalog.

Fig.20. The Bombay Chronicle, 15 June 1918. Internet Archive.

Fig.21. Ismat, 1910. British Library Endangered Archives Program.

Female commuters and Covid-19 in Karachi

By Ushna Khan

Acknowledgements

I would like to express my gratitude to my supervisor, Dr. Hadia Majid for her valuable and constructive guidance during the development of this project. Also, I wish to acknowledge the Saida Waheed Gender Initiative for funding my research and trusting me with this research work.

Female commuters and Covid-19 in Karachi

In March 2020, the government imposed a lockdown in Karachi due to the rising spread of Covid-19. Many transport services were temporarily suspended which created mobility issues for people. Women were believed to bear the brunt of this suspension. An attempt was made here to document the experiences of women in Karachi and to highlight any struggles that they may have faced. Future decision making by organizations, transport providers and governments can be more gender conscious by taking these research findings into account. This research focused specifically on working women in Karachi who were employed in white collar jobs to assess the overall effect of the pandemic on working women with regards to their commute routine. Data was collected via semi-structured interviews and structured surveys and 54 responses were collected in total. In addition, transport providers and three other women from outside the above mentioned category were interviewed as well. Results showed that most of the women reported a change in their commute either due to relying on a different mode of transportation or time taken to commute. These changes affected them monetarily and most witnessed a reduction in cost. Moreover, exhaustion level decreased while comfort level increased for most. There was a slight indication that women who were working from home felt an increase in productivity but overall there was no clear effect on productivity for women who still travelled to the workplace physically. Finally, it was revealed that most of the organizations that these women were employed in, were quite accommodating and introduced gender centric policies which allowed these women to be comfortable during the pandemic.

Introduction

By now, it is evident that the pandemic has had a far wider impact on the world that is beyond the scope of global health. It is deepening pre-existing gender inequalities in society and the spillover effects are to be seen in social and economic changes that are occurring as a result. Globally, research has suggested that women are likely to suffer the economic impact of the pandemic greater than men. This poses a greater threat to women in developing countries, as in addition to economic challenges, availability of other resources such as transport services are also not adequate. Particularly in Pakistan, there has been extensive research prior to the pandemic which showcased the sufferings of women commuters who rely on these meagre transportation options available locally.

Due to the pandemic and lockdowns imposed to contain the spread of the virus, transportation services had been halted in Karachi. In the third week of March, transport services within Karachi were suspended by the Sindh government. Ride-hailing services such as Careem, Uber, Swvl and Airlift also decided to suspend operations as a 15-day lockdown was imposed on 23rd March. As cases of Coronavirus increased, the transport lockdown was extended and finally on June 3 the government allowed public transport to resume their services provided that they complied with the Standard Operating Procedures (SOPs). The SOPs required all to practice social distancing, wear masks, use sanitizers and placed restrictions on the number of passengers seated at one time. Despite warnings of the consequences of violating the SOPs, these guidelines were flouted (“Public Transporters Flout SOPs as Services Resume in Karachi”). Soon after on June 18, a two-week long smart lockdown was imposed in certain districts where private and public transport services were again banned. These lockdowns created difficulties for residents of the city and restricted mobility.

This research aims to document the impact of the pandemic and transport lockdowns on women who have to commute to work in Karachi and investigate any possible struggles or opportunities that the changing situation may have created for them. While research has been undertaken on women and commuters in Karachi, most of this focuses on a very specific sample comprising of women from low income groups who use public transport mostly. Instead, this research will comprise of women, employed in white collar jobs. Data will be collected via interviews, surveys and observations and studied together with secondary literature to better understand the results.

Research Question

As defined by Sun et al., “Commuting is a daily travel behavior caused by the spatial separation between a person’s place of residence and place of employment” (1). The study will use this definition and commute routine will be understood as the normal commuting behavior of people on an average day. In terms of changes to this commute routine, three factors will be considered, namely: i) mode of commute ii) time taken to commute iii) elimination of commute i.e. work from home (WFH). WFH will be understood as a difference in the mode of commute- telecommuting¹- and a reduction of commuting time.

The prime purpose of this study is to document and investigate the impact of the pandemic on working women who commuted to work normally in pre-pandemic times. The research will specifically study the monetary effect, job performance and the overall wellbeing of working women during the pandemic with a particular focus on their commute routine and any changes to it. Here, overall wellbeing will be understood as comfort level, exhaustion level and experience of dealing with the changes to commute routine during the pandemic. In doing so, the research will also look into the conveyance policies employed by different organizations to cater to their female staff during the pandemic and if these are deemed satisfactory by the female employees.

Three overarching research questions that it aims to answer are:

Have there been any changes to the normal commute routine of working women during the pandemic and has this resulted in any struggles?
How have changes to commute routine impacted them monetarily, their comfort level, exhaustion level and work productivity?
Are the conveyance policies employed by workplaces during the pandemic to cater to female staff, satisfactory?

Background

International Labor Force predicted about 81% of the global workforce to be affected by partial or full lockdowns due to the current pandemic of Covid-19. A gendered centric lens has shown that women’s productive and economic lives are to be more severely affected as compared to men’s by this (Policy Brief: The Impact of Covid-19 on Women 4; Alon et al 9). This is mainly due to social distancing and inevitable lockdowns because of which many sectors with high female employees are witnessing drops in employment (Tariq and Bibler 8). It is important to note that women tend to be employed in jobs that require greater in-person interaction informal employments which makes them more vulnerable to economic recession during the pandemic (Avdiu and Nayyar 9; Anwar et al, 11). In addition, as telecommuting rises to popularity worldwide, 28% of men, but only 22% of women are employed in these easily telecommutable jobs (Alon et al. 9). This is coupled with the fact that as schools and day care centers close, women are also burdened with additional child care (Alon et al. 1; Hupkau and Petrongolo 6). Thus, the current situation increases gender inequalities and stands to harm women a lot more, globally.

In Pakistan, female labour-force participation rate in urban areas is extremely low. In fact, it was recorded at 11% in 2015, as compared to 15.5% and 14.7% for urban areas in India and Bangladesh respectively (Chaudhary and Verick 12; QLFS 2017). It is pertinent to note, that over the last two and a half decades this rate only increased by 4% (Amir et al. 3). Many factors contribute to these low rates of women labour force participation including inadequate transportation services. As explained by Dear and Wolch (1989), “accessibility to transportation is a necessary precondition to accessibility to the workplace.” A gendered- centric lens points out that women are more dependent on public transport due to non- availability of other options as opposed to men (Rapid Assessment of Sexual Harassment in Public Transport and Connected Spaces in Karachi 10). As a result, women’s ability to work relies on access to transport services (Smith, 2008). However, female commuters in Karachi have limited transport options to choose from. Users of public transports such as minibuses, coaches and busses face many issues such as lengthy duration of travel, high fares, overcrowding during peak hours, limited hours of operation, absence of schedules, inadequate coverage of routes, lack of safety due to rash driving, pollution and poor condition of the busses (“Urban Poverty and Transport” 226-229). Another deterrent to the usage of these by women are the social norms and security concerns which further restricts women’s mobility and prevents them from taking up paid employment (Field and Vyborny 1-3). Many women complain facing sexual harassment when using public transport (Overcoming Barrier’s to Women’s Mobility in Punjab; Rapid Assessment of Sexual Harassment In Public Transport and Connected Spaces in Karachi 3). In a study undertaken by the Centre for Economic Research in Pakistan, 70% of the males stated that they would discourage the females in their family to use public wagons (Sajjad et al. 1). These lacking transport facilities directly impact the livelihood opportunities for about 30-40% of people belonging to the low income groups in Karachi (“Urban Poverty and Transport” 231).

Women who belong to the middle or upper income groups, hence, prefer to rely on alternative private and other modes of transport. Research shows that as personal income increases women tend to rely on automobiles for travel. Ownership of a vehicle in the household also significantly increases usage of these for daily trips by women much more as compared to males (Adeel et al. 12). In fact, Dobbs argues that access to private transport ensures women’s economic inclusion in society (276). Considering these pre-existing hardships for working women in urban places, this research looks into aggravations to mobility struggles that the pandemic may have caused.

Literature Review

It is well known that commute mode choices are influenced by several factors including travel time, travel cost, comfort level, and etc. (Gong and Jin 4). But now, due to the pandemic, there are other considerations which are influencing people’s decisions. A study by Jones Lang LaSalle showed that 34% of the participants who used public transports wanted to look for other alternative modes of transportation in light of the pandemic (Beaudoin et al. 2). Kloof and Kensmill further researched that the impact of the pandemic on mobility will be higher on women as compared to men. It pointed out that women will face greater hardships in reaching their destination and will have fewer alternatives at their disposal (9). But this impact may be short term. There is also the probability that in the long run, once telecommuting increases, flexible work arrangements will improve gender equality as women are able to combine career and child care needs (Alon et al 17). It must be noted though, that while it may give women greater opportunities, women who are telecommuting during the pandemic are suffering emotionally more than men (Lyttelton et al. 32). It may also not be possible for all women to switch to telecommuting as research has shown that telecommuting during the pandemic was mostly adopted by younger people (Brynjolfsson et al. 4).

Commuting not only has an economic effect on female workers but has other spillover effects as well, such as on comfort level, exhaustion level or work productivity. Ma et al. defines employee productivity as the “efficiency of a worker”. The commuting behaviour, including mode of transport and distance travelled, shapes a person’s job performance. In fact, happy commuters who travel shorter distances tend to be more productive at the workplace (1). Moreover, those who work from home tend to have better work performance (Bloom et al. 19). On the other hand, employees who travel longer distances are more burned out (Evans et al. 522). Additionally, after the commuting journey, the entire experience “spills over” into how employees feel and perform at work (Ma et al. 1; Chaterjee et al. 1). This poses deeper consequences for women as they tend to feel greater stress due to commute (Chatterjee et al. 8). However, employees who work from home may have greater productivity but it also results in “job intensification and a greater inability to switch off “(Felstead and Henseke 1).

Results Summary

Results showed that 70.3% of the women witnessed a change in the mode of commute and out of these 58.1% reported working from home(WFH), while 11.1% used a different vehicle. Women who drove themselves to work or relied on office cars also faced minimal changes to their mode of commute. Concerns about hygiene, availability of service and cost involved shaped these decisions. Also, mainly younger women who had joined the job market in the last two and half years faced greater struggles with regards to changes in mode of commute. This was confirmed by interviewing three female students employed in part time jobs. The travelling time also decreased for 81.4% of the people and the reasons were either WFH or reduced traffic.

Changes in mode and/or time, resulted in 68.5% of the respondents reporting a decrease in costs incurred and 7.4% facing an increase. Most women who were WFH had no cost of commute, but a few continued to pay their drivers or vans services because they did not want to deprive others of their earnings during the pandemic. Extra costs incurred when commuting to the workplace were also removed due to this. Reasons for increase in costs consisted of a spike in prices charged by ride hailing services, using a different kind of vehicle or increased travel time.

Studying the impact of these changes on exhaustion and comfort level showed that as the mode of commute switched to telecommuting, exhaustion decreased and resulted in increased comfort. Even women who were still travelling to the workplace felt a decrease in exhaustion due to less traffic provided there was no change in mode of commute. However, those who used a different vehicle felt a decrease in comfort level. Women who were WFH faced an increase in productivity level and findings suggested that commuting to the workplace (via a vehicle or by walk) did not affect level of productivity during the pandemic even though travelling time was slightly reduced. Changes in mode and timing also resulted in most working overtime and a larger quantity of these participants were WFH. It appeared that due to this overtime, many reported increased exhaustion and decreased comfort despite spending less time in commute.

Based on the interviews, approximately 68.7% of the women felt that the policies employed by the organization during the pandemic with regards to female employees were quite accommodating. Many allowed these women to WFH or reduced the number of days they had to work from the office. It seemed that the reason for such gender centric policies was mainly due to cultural values and lack of availability of adequate transport services for women.

Research Design

Data Collection: Data was collected via qualitative interviews, quantitative surveys and field observations. Interviews followed a semi-structured approach and most were conducted over the phone, while a few were conducted in person. Most were recorded, but those in which participants had reservations were not. For such interviews, notes were made directly after the interview. Participants were given PKR 200 worth of mobile credit as an incentive to participate in the research and were informed that their identities will remain anonymous. Surveys were circulated online on Facebook groups and WhatsApp Messenger. Field visits were made to observe the condition of transport services operational across the city during the pandemic which comprised Careem, Uber, Public busses and Auto Rickshaws. Besides the main participants for the research mentioned above, conversations were also held with employees of Careem and Swvl, public transport providers, and three in depth interviews were held with female students involved in part time irregular jobs.

Sample: The interview sample comprised working women who are employed in fulltime or part-time jobs since before the lockdown and earn a regular salary. Only women who had to physically commute to the workplace pre-pandemic were asked to participate. All participants for the interview were employed in white collar jobs in Karachi. The interviews were conducted via random and snowball sampling. 32 people were interviewed and if any information was missed out in the interview or deemed essential later on, participants were contacted again.

For the survey, respondents were working in white collar jobs in Karachi. Voluntary response sampling was used. 26 responses were received on the survey. 1 was removed because the answers appeared to be filled randomly without proper thought or following any logical pattern. 3 were removed because it seemed that due to a software glitch, double responses had been obtained from the same respondent. Final survey sample included 22 responses.

The sample hailed from different areas of the city namely:
Gulistan-e-Johar, DHA, Clifton, Gulshan-e-Iqbal, Orangi Town, North Nazimabad, Nazimabad, Nagan Chowrangi, PECHs, Karachi University Road, Hassan Square, Bahadurabad, Askari IV etc.

Some of the workplaces included: The City School, Generation’s School, The Froebel’s School, Habib University Foundation, St. Joseph’s College, Shanghai Electric, English Biscuit Manufacturers, Haider Waheed Partners DHA, Southcity Hospital, Indus hospital, Omi hospital, Khaadi, Engro Corporation, Martin dou, United Bank Limited, Gesellschaft für Konsumforschung (Gfk), Unilever, Aman Foundation, Hilal Foods, NBP Funds, Wavetec Private Ltd. Etc Refer to Table 1.

Table 1: Distribution of Sample as per profession and/or industry

Industry	Survey	Interview	Total
Teachers (Education)	3	8	11
Doctors (Hospital)	2	7	9
Lawyer	1	4	5
Administration Admin (Education)	2	1	3
Banks	2	1	3
Other Organizations	7	10	17
Government sector	-	1	1
Unclear	5	0	5
Total	22	32	54

Findings

A- Changes

Changes in Mode of Commute

Results obtained, as seen in Table 2, revealed that 70.3% of the women witnessed a change in the mode of commute. Out of these, 32 (58.1%) had to work from home during the pandemic for varying amounts of time. This meant that the mode of commute was completely changed from physically travelling to virtually connecting with colleagues online and replaced by telecommuting.

Table 2: Mode of commute used pre-pandemic and post-pandemic

Mode	*Pre- Pandemic Survey	Post- pandemic Survey	Pre- pandemic Interview	Post- pandemic Interview	Total
Drive car myself	6	3	7	4	20
Family drops	1	3	4	4	12
Car & Driver	10	5	6	3	24
Careem/Uber	1	1	5	0	7
Private Van	4	2	5	2	13
Airlift/Swvl	2	0	1	0	3
Carpool	2	1	2	0	5
Office Car	2	0	4	5	11
Rickshaw			2	2	4
Walk			2	2	4
WFH	0	11	0	20	31

*Survey respondents were asked to select at maximum two most used options of commute to the workplace before the pandemic and during the pandemic.

22(40.7%) of the women who reported going to the office during this time continued using the same mode of transportation while 6(11.1%) women relied on different means of transportation as seen in Table 3. As per the information received in the interviews and the survey, it appears that during the pandemic women’s preference for mode of commute changed as different factors started to weigh in. Those women who were driving themselves to work were clearly least affected by the pandemic in terms of mode of commute. There was only one woman who had to switch to a Rickshaw from driving her personal car because her husband was using the housecar to go to his workplace. Similarly, those women who were travelling via office cars also faced minimal changes and continued with their mode of commute as normal. One reason for this was that the office car drivers and passengers were more likely to follow the SOPs and while public transport was suspended these remained operational.

Table 3: Switches made by 6 women in mode used to commute post-pandemic

No.	Pre-pandemic	Post Pandemic
1	Private Van Service	Carpool
2	Office Car	Family drops
3	Drive car myself/Carpool	Rickshaw
4	Car & Driver/Careem	Careem
5	Careem/Rickshaw	Office Car
6	Car & Driver	Family drops/Rickshaw

For others, there was a trend to use the mode of transport that would be safest in terms of hygiene. Hence, women preferred relying on family members or transport services that were not as crowded. Even though commuting via a personal car and driver was a popular choice earlier on (29%), during the pandemic, 12.5% of these respondents switched to other modes. The reason being that during the pandemic people let their drivers off, as they were scared for the drivers’ health and were practicing social distancing. Also, another reason for change in mode of commute appeared to be the suspension of transport services, forcing people to rely on private modes such as carpooling. But carpooling also became tougher as most people were working from home and so women had lesser colleagues to carpool with.

Women in younger positions who had only recently joined the job market (within the last 2.5 years), tended to rely more on ride-hailing services and office provided cars. Thus, in the interviews, this sector expressed more grievances about changes in mode of commute in terms of using a different kind of transport service during the lockdown, as seen in Table 4. In fact, 1 participant clearly mentioned that if asked to come to the workplace during the lockdown, it would be impossible for her to do so. This finding correlated with the three separate interviews held with female students employed in irregular part time jobs who mentioned that commute issue was an integral factor in job choice² and commute struggles during the pandemic had significantly increased.

Table 4: Changes in mode of commute as per work experience

Overall work experience (years)	Same Mode of Commute	Changed Mode of Commute	Total
3 or more	13	2	15
Less than 3	7	10	17

Changes in Time taken to commute:

Of all the participants, 41 (81.4%) reported decreased travelling time as seen in Table 5. Out of this, 16 (39%) were those women whose travelling time decreased due to reduced traffic on the roads. Only 3 (5.5%) women reported increased travelling time. This was due to blockade on roads which required detours and switching to van services which had to drop off many passengers. In addition, one respondent whose overall time decreased still complained about being frequently stopped by police officers to inquire the purpose of travel during the lockdown.

Table 5: Changes in time taken to commute

Less Time or WFH	More Time	No change in time
41 (81.4%)	3 (5.5%)	10 (18.5%)

Changes in Cost of commute

Participants were asked about reduction in cost of commute which could be either due to WFH or otherwise. 37 respondents (68.5%) reported a reduction in cost incurred due to commute out of which 28 were those who were WFH for a certain period of time³. Even though some of these people who were WFH faced decreased costs overall, those who had personal cars and drivers continued to pay their drivers a monthly salary. This meant that the cost of fuel was saved but the cost of a driver remained, whose services they were not even utilizing. Thus, it almost served as an additional cost.

Table 6: Changes in Cost of commute

Decreased Cost	Increase	No change
37 (68.5%)	4 (7.4%)	13 (24%)

For 13 (24%) women, the cost of commuting did not change at all. This included 2 people who were WFH but had to incur the same cost as they used private vans and fees had to be paid. 2 were those who walk to the office normally, and the pandemic did not create any changes to their routine. The rest of the 7 women continued using the same mode of transport and no other variables affected their cost.

Even though the prices of fuel decreased, the number of cars on the road decreased and in general people had to travel to work less frequently, there were 4 (7.4%) respondents whose cost of commute increased during the pandemic. The reasons for this included:

change in the mode of commute: One participant had to use the more expensive option of Careem car instead of the cheaper Swvl bus due to social distancing concerns. Similarly, another had to rely on public transport and family members instead of using her personal which was driven by her old aged driver due to concerns for his safety.
road blockages increased travelling time
ride hailing services increased prices

Other monetary effects:

In the interviews, participants mentioned other factors which affected their monetary situation due to WFH. As these women stayed home, they saved up on the extra costs incurred when attending office in person. A couple of women who were working from the home also experienced a little job insecurity due to not being physically present at the workplace. One particular interviewee stated that she felt insecure about her job during the lockdown, because her male colleagues were asked to come to the office but not her. The underlying reason for this appeared that cultural factors in Pakistani society and transport limitations for women generally meant that special policies were implemented to cater women in such scenarios. However, none of the women lost their jobs during this period. But, 1 respondent reported having missed out on job opportunities due to her commute struggles during the pandemic⁴.

B- Exhaustion level, comfort level and productivity level

Next, the effect of changes in mode of commute and time taken to commute were studied on exhaustion level, comfort level and productivity level. The Survey will be used to present results quantitatively while data from the interviews will be presented qualitatively to provide a deeper understanding. Quantifying the data of the interview without compromising on validity of results would have been impossible.

Interview Results for WFH (19 women): A clear link was established between exhaustion level and commute. Women who connected to their colleagues online from home without physically travelling to the workplace felt a decreased level of exhaustion. This was described as increasing their comfort as besides avoiding the physical exhaustion, it also saved them from mental anxiety felt during traffic jams, hiring a cab etc. Removal of commute also allowed these women to feel more relaxed as there was no fixed time of arrival at the workplace in the morning. However, as time boundaries started to fade away, many (9) women felt they were working overtime.

No substantial trends were discovered between productivity level and commute. 5 women felt their productivity increased while it decreased for 4. Perhaps, a division by profession will help provide deeper insights. It was noted that most teachers felt overburdened but this was probably due to the workload of online teaching.

Interview Results for women commuting to the workplace (13 women): Women who were still commuting to the workplace during the lockdown via the same mode felt more comfortable due to a reduction in time taken however there was no strong response for effect on exhaustion level. There were 2 respondents for whom time increased and accordingly so did exhaustion. 2 out of the 3 who had to change their mode of commute were uncomfortable as they switched from personal cars to rickshaws and were afraid of the unhygienic conditions. There was no change at all on productivity level for any of these women.

Survey Question Responses: For this part, 14 responses were obtained instead of the expected 16. 2 participants left their answers blank for this section.

1. Question: "Due to difference in MODE of commute during the lockdown... [I feel more exhausted]

As seen in Table 7, most participants felt a decreased level of exhaustion due to changes to mode of commute and these constituted mainly WFH women. Similar trend was observed in the interviews.

Table 7: Answers to "Due to difference in MODE of commute during the lockdown... [I feel more exhausted]

Responses	Yes	No
Total	5	8
WFH	4	6

2. Question: "Due to difference in MODE of commute during the lockdown... [I feel more comfortable]

Table 7.1 shows that WFH was linked to an increase in comfort level and women who were WFH were clearly more comfortable during the period of the pandemic. Similar trend was observed in the interviews.

Table 7.1: Answers to "Due to difference in MODE of commute during the lockdown... [I feel more comfortable]

Responses	Yes	No
Total	9	4
WFH	7	3

3. Question: "Due to difference in MODE of commute during the lockdown... [I have to work overtime]

As observed in the interviews, working women had to put in greater time into their work life during the pandemic, especially those who were WFH. Refer to Table 7.2:

Table 7.2: Answers to "Due to difference in MODE of commute during the lockdown... [I have to work overtime]

Responses	Yes	No
Total	8	4
WFH	6	3

4. Question: "Due to difference in MODE of commute during the lockdown... [my job performance is affected]

If studied along with the results from the interview, it appears that WFH increases productivity level as seen in Table 7.3: Also, this confirms the interview findings that commuting to the workplace (via a vehicle or by walk) did not affect level of productivity during the pandemic.

Table 7.3: Answers for "Due to difference in MODE of commute during the lockdown... [my job performance is affected]

Responses	Positively Affected	Negatively Affected
Total	8	3
WFH	7	3

5. Question: "Due to the TIME difference during the lockdown....

Table 7.4 shows that as timing decreased most women reported feeling more exhausted as compared to more comfortable. The reason for this could be that despite WFH or less traffic on the roads, the reduction in time was replaced by the over timing experienced due to WFH (refer to Table 7.4). Most women had to put in more hours. No strong trend was discovered between productivity level and timing of commute which resonates with the findings of Table 7.3.

Table 7.4: Impact of Time difference on comfort, exhaustion & productivity of survey participants

	More Comfortable		More exhausted		Have to work Overtime		Productivity positively affected		Productivity negative affected
Time	Yes	No	Yes	No	Yes	No	Yes	No	Yes	No
Less	7	8	8	6	10	5	7	8	6	9
More		1	1			1		1		1

C- Organizational policies during the pandemic

Interviews revealed that most of the organizations where these women were employed were quite accommodating with respect to these women’s individual concerns. Those women who requested their offices for extension of the WFH period due to commute concerns were allowed to WFH. In addition, it appeared that offices adopted gender centric policies. Most reduced the number of days’ women were asked to come to the workplace in person and others allowed them to WFH. However, this could result in female employees missing out in the long run, and alternative policies may be needed. WFH participants reported feeling job insecurity or being unable to work at full capacity due to a lack of office resources. All the offices which were providing company cars to women for commute, continued to do so during the lockdown and one company started a special car service for women during the lockdown. This allowed women to continue their jobs smoothly, just the way their male colleagues were. Lastly, only doctors had to continue working from the workplace throughout and this appeared to be so due to the nature of the job.

Conclusion:

Working women in Karachi who have to commute to work normally were clearly affected by the government imposed transportation lockdown and the pandemic in the city. Some had to switch to an alternate mode of commute while others witnessed a change in commute time consumption. These factors changed their costs and had a wider monetary impact on them. Accordingly, their exhaustion, comfort and productivity levels were also affected to a certain extent. Even though policies were adopted by organizations to cater to their female employees during this period, the pandemic brought into focus the issue of female mobility in Karachi for the larger population. As working women begin to return to their workplaces and resume their previous commute routine, the risk of virus transmission during commute lingers on. It is also not enough to ‘accommodate’ the females by letting them telecommute but they should be given an equal opportunity to attend the workplace in person. Hence, the need to re-organize these transportation services, as the pandemic stays, emerges and this paper provides a comprehensive guide to the experience of women with regards to commuting during the pandemic. Moreover, in the case of future lockdowns, this research provides insights into the greater impact on women employees and can help organizations come up with policies that are more considerate of the needs of female staff.

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Annex

A- Survey

This research aims to investigate the impact of the pandemic on working women in terms of changes to their routinely commute (i.e. mode of commute, frequency of commute and timing of commute in normal work-life) due to the pandemic. Your identity will remain anonymous.

Q. What is your current job designation?

Q. How did you commute to work pre-pandemic? Check at most 2 options or less

I drive myself to work
Family members drop me in a car
Personal Car and driver
Careem/Uber car
Private Van service
Airlift/Swvl Bus
Auto Rickshaw
Public Bus
Motorcycle
Carpool with colleagues
Other

Q. How much does commute to the workplace cost you in a month (pre-pandemic)?

- < Rs. 10000
- Rs 10000-20000
More than Rs. 20000

Q. How did you commute to work during the lockdown? Check at most 2 options

I drive myself to work
Family members drop me in a car
Personal Car and driver
Careem/Uber
Private Van service
Airlift/Swvl
Auto Rickshaw
Public Bus
Motorcycle
I work from Home
Carpool with colleagues
Other

Q. How much did commute to the workplace cost you in a month during the lockdown?

I had no cost of commute
Stayed the same
Increased by 5000
Decreased by 5000
Increased by 10000
Decreased by 10000
Other

Q. “Due to the work situation during the lockdown…

My travelling time increased	Yes	No
My travelling time decreased	Yes	No
I have to travel to work less frequently	Yes	No
I have to travel to work more frequently	Yes	No

Q. “Due to changes to my commute…

(Changes to commute here means change in mode of commute, travelling time or how often you have to travel to work)

I feel more exhausted	Yes	No, not at all
I feel more comfortable	Yes	No, not at all
I face job insecurity	Yes	No, not at all
Affecting job performance	Yes	No, not at all

Q. Where do you work? Optional

B- Interview

My name is Ushna Khan and I’m a student at Lahore University of management sciences. Today is August Xth and I will be interviewing – for my project focused on studying the experiences of working women in Pakistan during the pandemic. This interview will be recorded, your identity will remain anonymous and the information will be used for research purposes. You may choose to opt out of this interview at any point in time. Are you willing to participate in this research?

Q. Where do you work and long have you been working?

Q. Do you work from home or do you have to travel to work normally? Part time or full time?

Q. Have commute related issues affected your job preference in the pre pandemic situation

Mode
Cost
Time
Frequency
Comfort

Q. How much does commute cost you normally in a month, pre-pandemic?

Q. Do you use public transport or private? What is your: Mode of commute?

Q. Time taken to commute?

Q. Frequency?

Q. Comfort level?

Q. Are any transport services provided by your workplace? Conveyance stipend?

Q. Have you been working from the office or home during the pandemic?

Office Work	Work from Home
How did you commute during the lockdown?
What is your prime concern when commuting to work during the pandemic?	What is your prime concern if asked to commute to work during the pandemic and lockdown?
How was your travel time affected by it?	Now that you no longer have to spend time commuting to work, how does that affect your work life?
Was your frequency of commuting affected?	Do you have to work overtime, now that employees don’t have to leave for home at a fixed time due to commute concerns?
Did the cost change? Additional cost?	How does this situation affect you monetarily? (no transport cost and WFH Cost)
	Do you face any job insecurity due to not being able to physically go to the office during the lockdown?
Has HR at your workplace employed any policies to cater to commute related issues during the lockdown?	Has HR at your workplace employed any policies to cater to commute related issues during the lockdown?
Has the introduction of remote working jobs opened you to work from home opportunities?	Has the introduction of remote working jobs opened you to work from home opportunities? Part time jobs?
Does this change in your daily commute affect you in terms of increased anxiety, exhaustion or comfort?	Does this change in your daily commute affect you in terms of increased exhaustion or comfort?
	Does restriction of commute, affect your work performance, in terms of limited access to office resources?
Do you prefer this change in commute and why?	Do you prefer this change in commute and why?
Did your gender restrict your mobility in any way?	Did your gender restrict your mobility in any way?

Foot Notes

¹Telecommuting is defined as “opportunities that workers are given to work from home rather than reporting to a centralized office location” (Siha and Monroe 2).

² Commute did not seem to be as integral a factor for the interview participants as it was for these 3 students.

³ It is important to note here that people had different schedules and frequency of travelling to the office. Some did not visit the office at all during the 5 months, while others moved between WFH and the workplace depending on the individual policies applied by the organizations

⁴ Moreover, 7(21.8%) of the women stated that the boost in remote working jobs during the pandemic opened them to part time opportunities or helped them work on their private businesses.

Pandemic Archives: Charting Queer Pakistani Identities

By Rameen Saad, Zainab Azfar, Urooj Fatima, Mashael Shah

Oppression and abuse are often an inescapable reality for queer people. The restrictions of quarantine, coupled with existing socio-religious discrimination within a home environment, may only exacerbate this. This project allowed us to explore the impact of the pandemic on the lives and identities of openly queer people who have now returned to their homes – as well as the domestic abuse and discrimination that they may face. By employing this methodology to amass a collection of first-hand stories, we will explore these new forms of self-confinement that spring new possibilities of identity formation. These constitute both forced and reassigned identities, displaying different ways in which the pandemic takes affect mentally and physically. Using these stories, a new means of community-building is formed, one borne from shared experience and emotion. Our purpose, thus, is to introduce togetherness in a time where we feel so far apart, a bonding beyond the realm of the physical.

Literature Review

In this age of neo-liberalism, it is key to note the construction of identity, as well as tracing the factors that govern it. Identity formation is thus put on a pedestal, where primacy is granted to significant cultural markers – namely religion, ethnicity, and sexuality. Rohit Dasgupta, in his book “Digital Queer Cultures in India: Politics, Intimacies and Belonging”, is noted to say, “A more appropriate and easier way to think about identity is to understand what it is not.” (2017; 31) Identity then becomes an entity with its own multiplicities, one that seems to cross corporeal planes and find root within the online as well.

Using our research and open-ended interviews, we draw our conclusions surrounding the formation of identity as a queer body and its pandemic-related impacts. New realms of imagination open up when you see the difference between existing through your queerness, rather than working to become a queer body. After ascertaining this road to self-actualization, we move on to see the different spaces that have been opened up for queer youth, especially amongst the cyberspace. The powers of community and empathy are pronounced here, displaying how due to this, there is a means to explore identity in a way that would not have been possible without social media. While these studies may not apply to each and every case we have explored, it is worthwhile to note the similarities drawn amongst queer Pakistani youths, if only to introduce a space of relatability and camaraderie within these hidden minorities.

‘Normal’ is an arbitrary term, one that has been homogenized to focus on commonalities that hold an ideological hegemony in society. These cultural moralities and norms thus determine queerness to be politically charged, becoming an umbrella term that “encompasses sexual as well as gender non-normative identity positions.” (Dasgupta 2017; 1) Heteronormative stereotypes are thus challenged by its very name. We look specifically at our own Desi, South Asian imagination to view our deep history of colonialism whose hangover we are still struggling to overcome. Laws reify cultural standards, echoing British colonial moralities such as the banning of sexual relations between the same sex. Charges such as these forbid the very existence of Queer folk, sending a message that they “should not be seen or heard in public at all.” (Watch 2013)

The act of undoing such moralities thus becomes both a lesson in unlearning the ethics you have been fed since childhood, as well as a revolution. New kinds of freedoms are invited here, creating activism within identity formation. To derive meanings from it is to note “activism … as a kind of ethical practice,” (Dave 2012; 6) a notion that was advanced by Michael Foucault in his work on the history of sexuality.

Foucault talked in detail of ‘ethical self-fashioning’, a term that “emphasized invention and creativity over the inhabiting of already given norms for proper behavior.” (Dave 2012; 7) Further, he breaks down the notion of a homosexual ascecis, providing a rethinking of ethics: it hinged on the “‘work at becoming homosexuals’—rather than ‘be[ing] obstinate in recognizing that [a person is].’” (Dave 2012; 7) Basically, he asserts that all the work done must not be in realizing you are homosexual, it is to exist with this was a recognized part of your identity, and thus become a part of your philosophical labor. The very act of going against what is considered the norm—formally referred to as “problematization”—gives birth to new emotional labors, establishing new relations as well as “arriv[ing] at a multiplicity of relationships.” (Dave 2012; 8) With this premise, new meanings are acquired and value is placed differently. (Foucault 1978)

Newer creative streams must be opened to channel this ascesis into. These extend to “new forms of care and relationality,” (Dave 2012; 8) away from laws, cultural moralities, and familial responsibilities. The act of desiring the same sex thus leaves the individual and personal sphere and enters one of sociability, one that must still be enclosed to exist. Within this enclosure, it blooms, becoming a space for safety and acceptance. In this vein, “acts of same-sex love [do not become] acts of resistance—they are experienced as acts of social and cultural invention.” (Dave 2012; 14)

The internet’s pivotal role in enhancing the queer identity worked to quickly make it “a symbol of the radical change that has swept across gay and lesbian Asia” (Dasgupta 2017; 3) by embedding itself within other social spaces. Due to this, it is important to note the entrance of the online domain to cope with the struggles of the offline. In this way, queer people could ‘interrogate’ themselves within notions of belonging, and how they navigate in this “new transnational space” (Dasgupta 2017; 4) while paying attention to their local identities. While the interrogation itself is self-serving, it allows space for conversations to begin that contribute greatly to the shaping of identity.

Queer spaces form a subculture within cyberspace, existing both in due to and in spite of hostility. They provide an escape, allowing contact through mainstream sites, Twitter, Instagram, and Facebook being a notable few. Teenagers and young adults make up the majority of this discourse as they grow up within this virtual atmosphere, using it as a social support in “an environment which appears non-geographically restricted.” (Dasgupta 2017; 30)

Even with this, hostility still exists even in online spaces, where forums are full of people who attempt to police one’s identity. In spite of this, they exist as an act of resistance, performing their own mini activism purely by existing in an unsympathetic space. Online identities thus word to allow the existence of offline identities, thus contributing to the allowance of identity formation in a world adverse to the existence of queer bodies.

Ahsan

Ahsan was not completely comfortable with his identity before the pandemic when he was a student at university, and still remains slightly uncomfortable with it. The pandemic in particular did not really affect his identity much.

He had his break through two years ago, when he came to terms with his own sexuality – before which none of his friends or family knew. He feared that their behavior towards him would change and that they wouldn’t “treat” him the “same”. Two years ago he started coming out to his friends, and also told his parents after being encouraged by his therapist. Going to therapy was a major reason behind his parents’ understanding. Ahsan’s therapist told them that his mental health was in shambles and they, being doctors themselves, understood and stopped “pushing” him. Despite them being “super religious” they were very “nice” when he came out. However, to this day, his parents don’t talk about his sexuality much, which is something he is okay with. “I don’t want to talk about it”. He finds it comfortable as no one is constantly “nagging” him or bringing up his identity. He further felt that he cannot talk about his sexuality, because it makes their relationship “awkward”.

Ahsan wanted to be at a place where his sexuality and his religion – Islam – could coexist. These sentiments led to an in-depth conversations with his parents about homosexuality in Islam and what it meant. Regardless of these initial discussions, he felt embarrassed talking to his “aged, religious” parents about his sexuality, primarily he felt as though he was pushing them to the point where they might not understand, or they might stop being as accepting. “I’m at my limit, if I push it a little more, it might go south”.

He expressed that his sexual orientation isn’t at the forefront of his personal identity because of certain “sacrifices” he has made to formulate his personality a certain way. He “pushes” it to the point where his sexual identity is secondary, although in “an ideal world” it would be the most important aspect of his personality. Here, during the pandemic, in the real world, he has pushed his sexual orientation away, even though he is “proud” of it. He mentioned that this was definitely because of societal expectations and norms, and not by choice.
“I did it because I had to, not because I wanted to”. Being his true self, in his opinion, would “cause too many problems”, so instead he opted for the “easy way out” and tried to be as seemingly “normal” as possible (“whatever normal means”). Perhaps Ahsan’s narrative and identity may not be affected by the COVID-19 pandemic, but it most certainly is by the homophobic, intolerant pandemic that is the Pakistani society.

At university, it was difficult for him to pretend to be “straight”, particularly because his friends who were openly out could not enjoy the same experiences as straight students. Ahsan wanted to enjoy his time at university and chose to put away his sexuality in favor of this. Being at university made it easier to escape reality as well as the hate he saw on social media. Classes, parties and going out made it easy to forget how scary reality could be for someone like him. He expressed how the hatred against the LGBTQ+ community is very intense in Pakistan, to the extent that his own friends – who were unaware of his sexuality – were often homophobic. “It was in my face and I couldn’t escape it”.

Social media often becomes very toxic because of all the negativity and hatred – both here and internationally. It started becoming “really claustrophobic” because there is no place where he could be his true self. This caused him to wonder how long he had to suppress his identity, and if it was best to just permanently suppress it.

Talking about space he mentioned he had his own room and wasn’t intruded upon. No one came in to talk to him unless asked to, which was certainly a privilege in and of itself. However, he expressed that despite everyone being there for him virtually and physically, it did get rather lonely. The ongoing pandemic caused more of a disconnect between him and the people surrounding him. This was moreso because his friends did not completely understand his situation, most of them being straight and unable relate to his experiences. “They don’t understand what I’m going through”, he added.

According to Ahsan, he did not have any queer friends because of rumors about him at university, prior to his coming out. For him, hanging out with queer individuals meant that he was confirming his identity. As he couldn’t have conversations with queer people at university, he turned to straight women who were not the “best” audience.
“They have a certain way with gay men”, and they started treating him like the stereotypical gay best friend who had to listen to their problems instead of having the opportunity to share his own.

He dealt with internalized homophobia, but only towards himself and was very careful about not being homophobic towards others. Due to others’ treatment of the queer community, he set certain standards for himself: to walk, talk and act a certain way.
“I was very hard on myself and projected it on myself”. After his parents were accepting is when a large part of it reduced. Yet because homophobia is so ingrained in our minds since childhood and through social media, small sentiments of that self-hatred remain. He would sometimes wish he were straight, or not what he is but “at the end of the day, it is what it is”.

Every time he came out to someone, he had to apologize profusely and reassure the other person that he was still the same. This in itself was a homophobic notion, because you’re apologizing for your own identity. He often had to “water down” how he truly felt and wanted to say to make it more digestible for his straight friends. He felt that had he been more overtly or stereotypically gay, the people around him would have had a harder time understanding and accepting. He had to constantly police what he said and how much he talked about his queerness. If his friends did express micro-aggressions towards the queer community, he overlooked it or forgave it because they are “trying” and learning, yet this causes him to limit his self-expression.
“I make it easier for them to accept me, instead of them working harder to accept me”.

In the male dorms, where he has to live whilst at university, toxic masculinity is usually at its peak. Ahsan recalled gay men in the dorms were “persecuted and excluded” from everywhere because of their sexual orientation. He believed that he was luckier with his group of guy friends who provided a safe haven. This coupled with his sociability and very digestible queerness led to people always “respecting” him.
He laughed as he said; “If I was any less social or didn’t have these friends I would have been exiled”. Although he thinks it shouldn’t be this way, he stated that one should have a support system or friend group that “protects” them.

Yet it was coming out to his parents that empowered him the most, because for him this meant not “taking shit” from others his age as his 50something-year-old parents accepted him for who he was. It boosted his confidence and his self-esteem, and he began to stop letting homophobic comments slide. He realized that people from an older and more rigid generation learned new ways, and “if they could do it, anyone could”.

Aisha

“Everyone in Lahore is gay!” , Aisha* retorted. Comparing her minimal exposure to the queer community in her home city with that of Lahore (where she resides during her time at university), she described her life before quarantine as one that gave her the space to explore her identity – in a way that she had not done at home.

In Islamabad, she did not know of “anyone who was gay”. However, upon moving out and arriving in Lahore, she quickly became accustomed to being around queer individuals – for her, a welcome change.

Aisha describes a supportive and open-minded friends circle. The people she surrounded herself with in her day-to-day life were accepting of her queerness. While it was rarely a significant matter of discussion, it was comfortably acknowledged even in mundane conversation. For Aisha, this constituted a crucial part of the “personal space” she had created for herself. She describes this not as a purely physical concept, but a mental state too. She expressed that this environment gave her the “space to be confused” about her identity, allowing her to discover it piece by piece.

Naturally, this changed once her college campus shut down amidst coronavirus fears and she was sent home to quarantine with her family. The experience of being in confinement for the last 6 months was at once pivotal in terms of self-discovery, but frustrating too. She now shares a home with her single mother and her 3 siblings.

When she had previously visited home, Aisha did not feel the need to assert her identity in obvious ways infront of her family. She felt that it wasn’t completely necessary, stating that “there’s a point in your life where you really don’t mind not sharing it with your family”. Before having to quarantine, Aisha had spaces outside of her home where she could express herself – amongst friends, at university, and so on. However, as those outlets slowly began to shrink, she found herself creating that space for herself at home.

Her sexuality had been an open topic of conversation with her mother well before quarantine. Aisha spoke about being “lucky” that her family was not one that was physically abusive in response. Her mother had asserted: “you’re my kid, I can’t not love you” – this was a particularly transformative moment in Aisha’s self-discovery. However, at the same time she felt that her mother was uncomfortable with her identity – she insisted that this would pass, that Aisha should focus on her academics and her career instead of matters of sexuality.

Her elder sister’s reaction, similarly, had felt disappointing – Aisha was told that it would “break her mother’s heart”. Naturally, these family dynamics re-emerged in quarantine. There have been times where Aisha has had to walk out of family discussions about the queer community – she often felt that the LGBTQ+ community was spoken of in a dismissive and disrespectful way. As a queer individual, having to partake in conversations that feel dehumanizing has been an emotionally tiring experience. Religion is a frequent topic of contention. Aisha has constantly been told by siblings that Islam does not condone homosexuality – however, she does not believe so. She maintains her religious belief system, and asserts this in family discussions.

A particularly challenging part of quarantine has been the feeling of guilt. Aisha describes her family relationships, stating that they hold each other’s opinions close to their hearts. Therefore, when she has chosen to be expressive of her identity, her mother has expressed her discomfort and “disappointment” with the person she is. The last few months have become fraught with inner-turmoil: balancing the desire to live her “truth” and the responsibility she feels towards her parents.

In the discussion of her life “before”, Aisha also pondered over the changes she had seen in non-platonic interactions. Prior to quarantine, these interactions had largely taken place in-person. They occurred naturally and “in the moment, and continued to be based in spending time with each other. However, the restrictions of quarantine have now reduced this part of Aisha’s life to short-lived interactions that take place behind screens. “It feels less real”, she says. Even when she did meet these people eventually, she found it difficult to become “invested” in these relationships. It felt as if it wasn’t ever going to “go anywhere”. These exchanges eventually boiled down to interests that were purely surface-level.

While quarantine was particularly limiting in terms of both family and romantic interests, Aisha was able to find solace in her friend group. She describes the entire experience as one of confinement but felt that she was “confined with” her closest friends. The process of self-discovery, therefore, was not one that exclusively took place outside of the home environment. In fact, it was in isolation that Aisha did “a lot of the unpacking” with regards to her identity. She describes it as a time where being by herself gave her the space to sit with her feelings, and become more accepting of them. As someone who greatly values emotional intelligence, she found herself appreciating the way that quarantine gave her the time to explore the previously untouched parts of her identity.

Aisha once again reiterated how “lucky” she had gotten – with an accepting group of friends, and particularly with a tolerant parent. These are privileges not often guaranteed to queer youth – especially in a culture that has historically demonized the LGBTQ+ community. Therefore, this period of confinement has been consumed with competing feelings of guilt and gratefulness. But most of all, it has remained a significant stepping stone in the exploration of Aisha’s identity as a queer woman in Pakistan.

Areeba

One’s journey of self-discovery is very rarely easy terrain to navigate, for Areeba the relationship with the self has always been a tumultuous one. Areeba describes herself as a “turbulent campaigner”, as per the Myers and Briggs’ 16 personalities test, stating that she has always had great trouble attempting to “reconcile the way I see myself now with the way I have been brought up to see myself”. The latter being influenced heavily by her parents, her education, socioeconomic status, religious identity and several other factors.

While society and her conservative parents dictated that she live her life a certain way, Areeba has never been one for following rules or staying within the lines. Growing up in an extremely confined household with a very strict mother who liked to have things a certain way and didn’t accept any form of deviation was very difficult for Areeba who’s disregard for her mother’s rules was a constant source of contention between them. Areeba felt as if she was not growing up to be the dutiful daughter her traditional mother wanted her to be. During her formative years, particularly during her A-levels Areeba greatly attempted to distance herself from her parents’ myopic views regarding religion and the conservative ways they viewed women and their bodies. Thus she has always felt comfortable in her queerness, her bisexuality not coming as a surprise to her despite it conflicting with the belief system she had been born into. She cites this as part of an essential process of coming into herself that cemented her desire to separate herself from her parents’ religion. “I realized that the religion I tried to conform to has no space for me, it was a process by way of which I accepted myself and accepted that I am a certain way and that comes before any other beliefs I have held in the past. It wasn’t much of an issue at the time as I saw it more as a question of what I have to expel from my consciousness to begin to accommodate myself.” Coming out to her family is something Areeba would never even dream of doing, the prospect of her parents ever finding out gives her a lot of anxiety, at home she is constantly on edge. She is fairly certain her mother has some sort of an idea about her sexual identity given that she has read her journals and attempted to sneak into her phone multiple times but it is a topic that has only been addressed in very vague terms.

Being the first individual in her family to receive a formal education, her parents constantly worried about Areeba straying from her extremely religious upbringing, thinking of the formalized education system as having westernized their daughter. Areeba would thus face several repercussions when she was caught breaking the rules such as having male friends which was considered morally ‘wrong’ by her family. One such repercussion that accompanied verbal and physical abuse was physical confinement, when her mother would lock her up not giving her permission to leave her house or meet her friends. When Areeba was younger she would choose not to fight back against the abuse but as she grew older she began to defend herself, often talking or fighting back would result in more severe punishments. According to Areeba her parents believed that physical confinement was an effective means of “taming” her, curbing her ability to rebel. Therefore, to return to such a toxic household following the closure of her university due to the pandemic was very challenging for Areeba, the idea of having to stay indoors and face a form of self-confinement was a concept she had difficulty wrapping her head around. “During the initial period of lockdown I kept questioning why quarantine felt so much like a punishment”, Areeba muses, “for me prior to this, confinement had never been a choice I had to make in order to save my life or that of my family”. Areeba’s mother in particular faces health risks that make her extremely vulnerable to disease and sickness, due to this Areeba spent several months within her family home in isolation, voluntarily confining herself to an environment that has always been very toxic and damaging for her, one that she has repeatedly tried to escape.

“I’m not the person I was before the pandemic, I feel like I’ve aged 10, maybe 15 years in the span of these few months alone”. Areeba viewed her attitude towards life pre-pandemic as drastically different to the way it is right now, she treated the chance she’d gotten to go to university as a new beginning, an escape from the home she grew up in and an opportunity to blossom in a new environment. She felt as if life had so much more to offer before the pandemic, now she feels extremely burdened by responsibility having had to move back into her family home and working full-time to support her parents given her mother’s health issues and pandemic induced financial setbacks. Before the pandemic she felt as if she only had to look after and be responsible for herself, “to be tied once again to your parents and to have them depend on you for their health while also focusing on your own mental health, coupled with not being able to escape these four walls is extremely overwhelming”. Areeba feels extremely alienated and misunderstood by her family, and since the pandemic this feeling has only gotten worse as she feels out of touch with reality, “being forced to come back is as if each cell of your body feels like it’s flailing for safety. It was really messy in the beginning, I couldn’t stop feeling like we are going to go back soon, I can’t be at home forever, I’ll eventually be able to go back to a life that I enjoyed living, my current reality now is something I’ve simply resigned myself to”, Areeba sighs wistfully. For Areeba, her university campus has been her safe space and she now longs for the sense of security and comfort it would bring to her, given the hostile environment she now finds herself confined to.

Bilal

To individuals especially those who identify as queer, a community is essential in creating a sense of belonging and a network of support. Bonding over shared experiences and trauma can also be a great source of healing for many who feel misunderstood and alienated by their families, or those who have been shamed, ostracized, and discriminated against for their identities. For Bilal, his “chosen families” are his safe spaces; individuals around whom he can be completely comfortable and at ease with, the truest version of himself that his actual family rejects. Coming from a household that was homophobic and therefore extremely intolerant of his identity, Bilal’s self-expression in terms of his gender and sexual identity within the sphere of his home was very limited. It was only when he was around his friends and individuals belonging to the LGBTQ+ community, or in spaces such as his university campus where he felt like he could embrace these identities freely. One of the biggest forms of self-expression being his unconventional and non-conforming way of dressing. Due to the pandemic, Bilal was forced to stay at home for a long period of time during which he was unable to access his safe spaces.

While Bilal’s siblings are more accepting and understanding of his identity, his parents have been rather restrictive in some regards. Thus, though the physical confinement that the pandemic heralded was a new experience for him, Bilal felt like he had been confined in several different aspects throughout his life prior to this. This occurred both at the hands of his parents as well as bad friends and bullies in high school who had an issue with various expressions of Bilal’s gender and sexual identity, reacting to this behavior by bullying or emotionally manipulating him.

At the moment Bilal’s current living environment at home is stable, however there have been instances during the pandemic where tensions escalated. Previous bad experiences regarding their reactions to his sexuality have marred Bilal’s relationship with his parents, he tried to come out to his family many years ago but due to the way they reacted he was forced to “go back into the closet”. The entire experience was very traumatic for Bilal who had to lie in order to convince his parents that his sexual identity was just a “phase”. Over the years, it is an event that has been brought up by many of his relatives repeatedly, due to which Bilal feels as if he constantly has to lie about who he is in order to protect himself.

Despite having been ostracized in the past, Bilal is extremely confident and comfortable with himself in regards to his sexual and gender identity. Having experimented previously, he feels as if he doesn’t really have any “cognitive dissonance” with regards to his identities. Bilal finds himself lucky enough to have found accepting friends both at university and during his A levels. Filtering them based on people he thought wouldn’t be homophobic or judgmental – a mechanism put into place to protect himself as he has been troubled by intolerant individuals in the past. In terms of space, Bilal feels as if he has created a good personal space for himself where family interference is limited, however, he muses that this decrease may be due to the multiple lies he has had to conjure up about himself in order to smooth things over with his parents. He doesn’t want to give them any reason to suspect him hence the lies created as a means of safeguarding his own wellbeing.

Bilal had never thought of himself as being strong enough or having the courage to, “say the things I said and make up the lies I did, in order to survive”, given that his parents are severely “heteronormative” and “religious” in nature, having constantly been indoctrinating Bilal, both in the past and during the quarantine period. However, Bilal saw this change occurring in himself after living away from home for the first time in his life where he began to feel more comfortable in his own skin. He attributes a large part of this change to his friends as well as his university campus as a space, both teaching him self-acceptance.

Fariha

Steering yourself in a region where sexuality is a stigmatized topic of discussion can not only impede one’s growth, but the very understanding of themselves – who they are as people. The tone of Fariha’s voice is casual as she explains the enormity of her struggle with her sexuality in her youth, the paths she took to conquer it in a heteronormative atmosphere, and how it remains a day-to-day process of learning and unlearning her own behaviors.

As she went from her early girlhood, to her young adult years, Fariha struggled with figuring out where her attraction strayed. Norms pointed towards crushes on men, while complex feelings towards women sprang up as she went along, unable to pinpoint the emotions. At age fourteen, she found herself decoding what she was experiencing, finding out about the spectrum of sexuality steadily through conversations with friends and those online. The social media platform, Tumblr, was her main avenue for the attainment of information, as well as where she found an online community of those who she completely related with. Being from Pakistan, her exposure around her was incredibly limited. The youth lack the required tools to explore their sexualities adequately, and those who manage to are frequently gate kept by religious factors. The emotional burden of familial and social expectations act as a rigid, self-imposed barrier that we now see breaking down through the emergence of online communities. Through this newfound relatability of the online, Fariha found herself able to understand the emotions she felt in the offline.

Still, she believed herself to be the only queer individual in her school as this level of awareness had not entered the mainstream. It was her friends who figured it out themselves, and provided a comfortable and honest environment of acceptance that allowed her to properly come out to her wider circle. It was there that she found her platonic affections for her best friend deepening, blossoming into her first same-sex relationship. She was around two years older than her, and was open about her sexuality in a way that allowed Fariha the space to explore her own and see it mesh into her identity, enabling her to function as a queer body instead of attempting to become a queer body.

From these avenues, she was able to untangle multifaceted aspects of her sexuality. Previously believing herself to be bisexual, she began to steer more carefully and identify moments where she felt the heteronormativity of society permeated her consciousness and decided her actions for her. As she described, heterosexuality to an extent felt compulsory, and thus led to encounters with men that left her more confused than before. While bisexuality itself exists on a spectrum, Fariha found herself hooking up with men only when she ‘felt self-destructive’, and realized that it ‘didn’t feel good’. There were feelings of repressed guilt and confusion with the self, as years of socialization in a Muslim country surrounded with heteronormative role models and media, the very act of loving one of the same sex did not feel normal. She slowly began unlearning these cultural notions, realizing her emotional attachment to men was next to zero. After a conversation with her close straight friend about these feelings, and the circumstances in which she usually consummated heterosexual romances, her friend simply asked one question: “Are you into men at all?” It was only then that Fariha allowed herself to critically and logically look at these instances with her newly learnt notions of sexuality, and cement herself in her identity as a lesbian.

Confidence built after these experiences, Fariha began to curate an online presence of herself that was unabashedly queer. Her pride around her identity allowed her to support the queer Pakistani community in different ways and partake in the discussion in a way that would help other queer youth. Upon entering her A-Levels, she expressed that people already knew she was queer. It was in university that she felt the weight of existing as a queer body functioning in a conservative, intolerant realm. She felt she had to ‘act straight’ to be accepted, as those around her were openly homophobic. She relayed one such event where someone she had just met from her university began to bash homosexuality in front of her, clearly with the perception that it was a sinful and wrong practice, effectively othering her in her new zone of comfort. This served as an indicator that she must again recede into her heterosexual mask, unable to maintain her own identity. The dangers of operating as a homosexual in a university were life-threatening, suffocating her within herself. This confinement effectively strayed into the quarantine period where she was locked into her home, again forced to live a lie amongst her family who would never accept her for who she is.

Here, Fariha became a little quieter, as if finally looking back at the extent of this period stuck at home. She continued, delving deeper into her life in a home where it is impossible to tell her own mother how she is feeling. She lives, she said, in fear. In fear of her parents finding out her truths, of the backlash, of the danger it will have to her life. How her functionality as a human being depends on this act of masking. “It’s like living a life of punishment,” she explains, “one that you can’t do anything about because you can’t change yourself. You just have to live with it.” She sounds as if she knows she was always meant for this fate, one where you have to exist day-to-day on edge to just survive. It goes deeper than merely lying. To ingrain straightness within your daily life is a conscious act, one that cannot be performed without mental repercussions. Shame roots itself within this identity, a constant fear that those outside her family, too, will find out and begin to spread rumors like rot, distorting her perception in the public realm as well as the personal.

This did not serve as a stand-alone factor in her confinement – it was physical as well, restricting mobility in a way she had stopped being accustomed to due to her university life. After the pandemic encroached upon her freedom, she felt the openness of living on her own dissipating into an area of complete confinement, one where she only saw the same faces over and over again. It became irritating, especially as her siblings were much younger than her, not allowing a space where she could freely communicate how she felt to an understanding body going through the same motions. Privacy was another area of discontent – she found it was extremely difficult to be alone now, as she shared her room with her sister. This led to other forms of escapism in the form of hashish, the drug allowing the means of coping with the extremity of the pandemic. One key form of this, though, was her relationship with art.

An artist and lover of anything to do with creativity, Fariha found safety within the canvas. No other way was as expressive as art, and she delved into it to forget herself. With her university shut, it was harder to access that level of creativity, and so acted as an inhibitor of her individuality. Aspects of her personality and identity, she felt, were being excessively hindered in this long run of lockdowns and restrictions. Previously, art teachers had not only accepted her identity, they encouraged the creation of art that could be based on, and hence enhance, her personality. Here, she found a lack of this acceptability.

A major chunk of her anxiety, she realized through therapy sessions, were due to the space she had been around in her environment and at home. This was a surprising discovery, as she felt she had been quite solid in her identity, but found that this self-conflict was owed greatly to the quarantine.

“The main problem with dating girls”, she expressed, “is that they, too, are still figuring out their sexuality. So you have to be focusing on your own identity formation as well as helping them.” This double weight on her shoulders served as a barrier in furthering relationships at what would be a comfortable pace, as the act of figuring out your sexuality is a constant process of unlearning in Pakistan. This induces an automatic response to safeguard your own feelings in case this blows up, and this fear leads to difficulty in expressing desire and emotion.

Steering as a homosexual, thus, becomes an act of revolution, but a silent one. One that operates privately, lurking skin-deep until allowed to blossom within communities of acceptance.

Hira

Having the space to regard oneself from an outside vantage and reassess one’s own identity is a privilege available to a few. Once born, a mentality roots in you to grow into an expected mold, one decided by parents, by social factors, and by cultural expectation. Carrying the weight of a stigmatized identity is an added burden on the psyche, on top of pre-existent gender-based and cultural anxieties. An important point of consideration is the burden of your parent’s dreams and hopes for you that is thrust on you from birth, hindering individual development and not allowing the space necessary to become comfortable in one’s own skin.

I listen to Hira recount formative instances of her youth, realizing each carries this burden with them, stamped into her mind from a young age. Her tone sardonic as she talks of the familial expectations placed upon her, of having to conform to protect not just herself, but her siblings as well who were exposed to the realities of a rocky family life from an early age. “I’m not seen for me,” she tells me, hurt brimming in her words. “I’m the trophy daughter, still expected to adhere to this teenage mold of the self that I’ve outgrown.” The main values that are expected to be upheld are conservative, religious ones, a consciousness developing wherein the existence of anything deterring from heteronormativity was non-existent. “I didn’t expect myself to be bi[sexual] at all,” she admits to me. It was only in school, when with people of the same energy and mindset as herself, that she was able to discover these more diverse ways of existing, and make sense of the feelings that had previously been too complex to understand. She had only come out to a few of them, preferring to keep under the wraps to safeguard herself. It was dangerous, she shared, to be found. Not just for her public life, but for the personal as well. There was an immense fear of being found by parents who lacked the tools and tolerance to handle such a reality concerning their daughter.

From the age of ten, Hira had come to the conclusion that her only way out was to leave the country and never come back. The living of a life on one’s own terms was impossible due to how strict and controlling her parents were. Toxicity had become a part of her daily life as she grew up around arguments between her parents, always feeling as if she had to be the protector of her other siblings, too young to know better. Religion was seen as ‘farz’ – mandatory – and was continuously shoved down their throats, being forced to pray until religion lost all personal meaning and merely became a tool of her parent’s control. Even with this parent-role she had adopted with her siblings, she could not protect them from everything. Even these young kids grew up the same way she did – having no relationship with their own parents, atheist, and much more aware than the average child. Growing up too fast, it seemed, was integral to surviving in their home. As the replacement parent, Hira found lesser time to focus on her own development, her childhood robbed, and felt she had lost her sense of identity and individuality.

“First, I strived to be the person my parents wanted me to be. Completely ‘good’ and obedient. It was only later I realized this wasn’t real. I couldn’t emulate the caricature they had of me in their heads.” What brought this change in perspective was the act of leaving home that she was able to achieve in university. She found she was cheerful and bubbly, a surprise to her as she finally had the time to get to know herself. The process of finding her footing in university itself was a feat on its own. Having not gotten into the university of her parent’s dreams, she was subjected to violence. Humiliated for things beyond her control, such as the admission process, she could only argue back so much until the topic became manipulative. She was accused of focusing on boys too much and deviating from her goals due to this, completely untrue and yet the label of ‘slut’ stamping itself in her mind as well as her parent’s perception of herself. In another instance, her father had gone as far as to accuse her of sleeping with a friend’s father, a ludicrous accusation with little to no basis. It was this shaming that impeded Hira’s progress with realizing her sexuality. Pursuing men in any sense became a form of self-flagellation, a reaffirmation of her parent’s accusations and a way to validate herself. This was further cemented when, in her university, she was publicly outed as a homosexual on a public confessions page, subjecting her to a torrential pour of hate, disgust and the discomfort of existing in her own body. Such an incident can not only traumatize you further, it stays in your very makeup as an individual, fear becoming part of your daily routine and outlook to life.

The difficulty in steering as a bisexual body in Pakistan’s cultural, political and religious atmosphere brings with it burning guilt as well as confusion. There exists a deeply imbedded power imbalance in the very goals we have and ideals we maintain. Such is life that women have to unlearn the mantra that male approval is the validation needed to survive. It is incredibly hard to overcome something so ingrained in our consciousness and daily rhetoric. Hira recounted her experiences with men usually sprang up when she was feeling particularly self-destructive and in need of sexual validation. She used Tinder as a means to communicate and find men who she would flirt with, feeling a temporary surge of power that was quickly replaced by discomfort. This only strengthened due to the pandemic.

The pandemic brought with it an incremental increase of toxicity and abuse in the home. She would take therapy sessions before, but was now unable to due to the existing taboo around it in her home. Left to her own thoughts, her progress with her individuality, self and identity gave way to crises. She regressed back to old bad habits, back to her low self-esteem, impacting her relationship with herself severely. Social interactions as a form of escape was unavailable, and she found herself suffocated and enclosed. She was, it seemed to her, exhausted by herself.

An avenue that she made the most use of, though, was cyberspace. Hira recounted feeling much more herself online, able to voice thoughts that would not be able to see the light of day otherwise. The existence of online spaces thus became a site for the growth of her individualism and personality, a place where she got to know more queer folk like her. These groups opened her up to acceptance in a way unknown to her previously, and she found herself meeting up with them as well and conversing regularly.

The presence of this space opened new possibilities and ways of thinking, inviting her to explore her sexuality further as she felt she was now allowed to. Within this space she met a girl who she allowed herself to fall in love with, going as far as to begin thinking of a future together. Still, she believed her to be straight and did not pursue or discuss any possibility of these feelings with her until the quarantine period, where she found the courage and ability to confess them to her. She was shocked to find that they were reciprocated, invoking confusion and more complex emotions due to this slowly budding same sex relationship. A new frontier to be explored, all through the online space and community-building.

Hira ended on a hopeful tone, as she had newly received admission into the university of her dreams, one that was far more liberal and accepting than the one previous. A blank slate to start over, something to write her own path and focus on her own identity. It is important, after all, to give yourself the space to grow, no matter where or who you are.

M & A

This interview was interesting because we had the chance to talk to a queer couple who had moved from living together to now being in two different countries because of the pandemic. Prior to the COVID-19, both individuals lived together in a hostel, living their “best life”. The recalled it being “great”, not having to leave the dorms to meet each other and instead having M camp out in A’s room.
“M got us a cake that read ‘From Your Third Roommate’”, and would spend all their time with each other, in A’s dorm room. Being away at college together helped both of them become more comfortable with their identity. A remembers that her friends weren’t surprised when she came out as queer to them, and M laughed and interjected that she knew her girlfriend was “gay” before her girlfriend figured it out herself. M, however, knew she wasn’t heterosexual before she began college, but coming from a conservative household and an even more conservative and religious country, she kept this information to herself. It was only after she arrived at college that she gradually began telling those closest to her, but dating a boy led to her not “thinking about that part” of her life. Gradually M got more comfortable with it and was no longer “bothered” by people knowing about her sexual orientation.

M recalled how she came out to her three brothers, all of them rather accepting. This made A chip in and say that “everyone expects it to be so dramatic, but its not!”
M’s youngest sibling, for example, said “acha, okay” and turned right back to his video game. A’s siblings were also aware of her sexuality but coming out was a very “underwhelming” experience for her.
“You expect someone to cry, but it was so lame”. Her sister’s reaction, she recollected, was “yes, and? I already knew”. Acceptance by siblings is a recurring trend among the queer individuals we interviewed, making the home becomes a partially accepting space, where certain members are aware and tolerant of queer individuals’ identity.

Forced to being at home led to a change of circumstances. A expressed that she wasn’t someone who needed constant reassurance in a relationship, and was okay without constant communication. M on the other hand felt more “insecure”, especially if she felt a change in someone’s texting patterns. Not talking to A about her day led to feelings of “depression”. M stated that if anything significant happened throughout her day she always called A on WhatsApp and informed her, such is the importance of one another in their lives. According to M, she tries to keep her “shit together” with the hopes that college online will end soon, and she can be reunited with A come spring semester. Currently she tries to keep herself busy, but it does get “pretty weird” not having any friends from college in another country.

Another salient aspect of being at home, and away from each other, is the constant presence of parents. M offhandedly mentioned how her mother was talking about marriage a little before our chat. For A it was quite annoying that her family joked about and discussed her brother’s girlfriend, yet she could not talk about hers. It was also rather infuriating for her that her parents were okay with homosexuality as a concept and other unorthodox couples, but would not have accepted their own child, is she came out. Her mother recently became more suspicious of her identity as A often jumped to the defense of homosexuality in front of other family members. “They always assume that you’re gay because you’re defending gays, but the two are not correlated. Well in this case it is”. She narrated an anecdote of going to the park with her mother, and her mother thinking that two boys sitting on a bench would have been a very cute couple. A and her mom are both aware of this hypocrisy of accepting and supporting other gays, but not being okay with their own child. If it had not been her mother, A would have “dragged” her for these double standards but since she has to “live with” her family she simply cannot. M reiterated that her parents were quite “conservative” and the topic of her sexuality simply could not be bought up. Instead her mother imposed a lot of gender roles on her, in efforts to pry her away from her androgynous mannerisms. She hated wearing earrings, so her mother always tried to make her wear them, told her to dress a certain way, sit a certain way, which according to M had no “logic”. She laughed softly and hoped that she wasn’t talking too loudly. For her, there is “no point” in talking to her parents about her identity.

In efforts to stay connected with each other in spite of the difference, M and A constantly text each other and talk every night (“It’s strange my mother hasn’t noticed,” M added). They also Netflix Party together, a website that allows multiple people to watch Netflix shows together and message each other simultaneously. A went on to list a number of shows the two watched together, emphasizing all the virtual time they spent together. The concept of Netflix Party became a means to recreate what was previously the norm – physically watching shows together – to a new, virtual normal.

With regards to feeling confined neither of them felt very strongly suffocated, but felt confined in general because of the pandemic. There was no sense of accountability when they lived at college and they could do pretty much whatever, whenever. Being at home, however, has led to life being more “annoying” because of more responsibility, although A admits to this being somewhat of a “privileged” sentiment.

A reminisced that when she was watching the TV show Schitt’s Creek with her parents, and a scene had a man being very nervous to come out to his parents. According to her parents, no one should have been that nervous, yet A hinted at the hypocrisy again stating that she would have been, had she ever wanted to come out to her parents.
“You [they] are doing the complete opposite… and it makes me want to pull my hair out”. Instead she opted to put these feelings away “in a box” and ignore them for now.

A lot of the insecurity with the pandemic came from not knowing and the “impending doom and the end of the world” attitudes. The end would have been in sight had this been a regular summer vacation.

M revealed certain objects that bought her comfort in these tumultuous times. Her mobile phone, which she of course used every day. Another object was a bracelet A got M at an old market place which didn’t “feel like much at the time”, but now M wears it daily saying that she feels “weird” without it. M had pointed it out and said she found it pretty, and A bought it for her right there, before they had started dating. Perhaps now it serves as a reminder of their time spent together.

(For anyone who would like to know, they are currently watching The Umbrella Academy together)

Mariyam

Pondering ideas of personal space and self-acceptance, Mariyam* quickly reached the conclusion that it has little to do with a physical place. To the contrary, it has everything to do with one’s interpersonal relationships and the people they surround themselves with.

For her, the people she is closest to are the most significant part of what she considers “her space”. However, she admits that the change in her physical environment as a result of quarantine was one that was stark.

She spends much of the year at university in Qatar. Mariyam is not “publicly out” due to laws which criminalize homosexuality in the country. However, she considers her college campus to be a safe place for self-expression. It was commonplace for her to don Pride clothing, and Pride Month was celebrated openly. For queer individuals on campus, it felt like a “proper community” – there was a sense of belonging. She did occasionally feel the need to self-censor out of concern for her on safety. However, there was an undeniable sense of comfort and openness on her campus.

Naturally, that changed when Mariyam returned to her home in Pakistan. As someone who is immunocompromised, she had to isolate particularly strictly. Over the course of 5 months, she was able to leave her home merely a handful number of times.

Describing herself as “extremely extroverted”, Mariyam goes on to explain that she feels stable only when she is surrounded by people. She attributes this to her anxiety and depression, which can grow to become unbearable if she is left alone for long periods of time. Consequently, this inhibits her day-to-day functioning.

The friends she typically surrounds herself are “like family”. She is not someone who likes to spend time with casual acquaintances and the like. These friends have come to play the role of her “safe space”. Crucially, they are all individuals with whom she feels wholly accepted – especially with regards to her sexual identity. She feels strongly about cultivating this space for yourself. Talking about people who challenge this facet of her identity, she remarks: “I’m not going to let you inhibit my space – that’s important for me to keep myself sane”. Her relationships with those around her are consequently determined by how safe she feels around them. Evidently, her personal space is one that has been crafted with intention and thoughtfulness – with a particular regard for her queer identity.

Therefore, her friends remain a particularly significant outlet for self-expression. Having this taken away from her during quarantine has been “challenging”. Her home environment is one where the importance of mental health is acknowledged – regardless, the inability to be physically present around her support system was a reality she had to cope with. Moreover, while she has understanding parents, she can not openly talk about many aspects of her life – particularly her queer identity. Although her home environment is largely stable otherwise, in some ways it has become “toxic” for her. She no longer expresses herself freely, and finds herself without the usual calming presence of her friends.

Confinement is not something Mariyam is unfamiliar with: Her university provides students with single accommodation. As someone who physically isolates themselves amidst depressive episodes, she recognizes the mental deterioration that comes with it. That, however, was confinement “out of choice”. Unable to control her current circumstances, she has often felt helpless.

Having returned to university in Qatar recently, she took part in this interview while still in the mandatory 2-week isolation period. While being at home was challenging, she was around family nonetheless. It was an important source of basic human contact – something she has been cut off from lately. As someone whose anxiety is alleviated by being around an understanding group of friends, the last 14 days have been anything but easy. The only reason she feels she has “survived” it is because she has the means to stay in touch with people over social media. Mariyam has found solace in connecting with her support system online, and keeping herself occupied with classes.

For Mariyam, her campus is a place characterized by openness and understanding. Once the mandatory quarantine period ends, she will once again be able to access the freedom she had become accustomed to.

Over the tumult and uncertainty of the last 5 months, one fact has become increasingly clear to her: personal safe spaces are not always physical. They can take the form of anyone, or anything, which makes one feel wholly accepted for all parts of their identity.

May

Before the pandemic, May was living at her university’s hostel, which allowed her to have more freedom than she was accustomed to having at home.
“I couldn’t do everything, but most things, almost everything, was okay and doable”. This new life let her be the person she wanted to be, despite her initially hiding her queerness from her friends. This, however, was such a significant part of her identity, that she could not truly connect with those around her, until they were privy into her secret – especially due to her “sharing” tendencies. At university, she felt “pretty good” about her identity, and slowly told those around her. She normalized her queerness to the extent that the people around her, who may have not been completely comfortable with the idea of homosexuality, became more accepting which in turn led to the notion normalizing for her herself. Yet May still feared that eventually, when university ended, she would have to stop doing things that made her “happy”, and being with people who made her “happy”.

May told me about a sense of ingrained self-hatred because of who she was, primarily because her identity at home was considered “wrong” and immoral. However, having people around her at university who accepted her and were part of the same community, helped her overcome such notions.

Returning home, because of the pandemic led to these feelings of internalized homophobia resurfacing again, especially since her parents were not okay with her queerness. For three years she distanced herself from the idea of self-hate rooted in her identity and was instead in a space where she was accepted. After the pandemic began and she was forced to return home, May started questioning herself and her feelings again – not loving the person she is, regardless of the fact that her identity and current partner bring her “happiness”. Of course, at this point she had to pause and relight her cigarette which had gone out because of her talking for so long.

As someone nearing graduation, particularly a woman, she pointed out, your parents tend to bring up your future which includes marriage. Being at home for a long period of time currently caused these sentiments to intensify, adding to the pressure. The worry in her voice was apparent as she expressed how “extremely difficult” it is to come to a decision where both her and her parents are satisfied. Because of her queerness she has to chose either her happiness and being with a woman, or her parents happiness and committing to a heterosexual marriage. All the empty time spent at home, and with the added pressure of her parents’ comments, May faced “very weird panic attacks”, leaving her rather shaken. Yet, she sounded oddly sure of the fact that both her and her female partner will end up marrying men in hopes of appeasing their families. The conflict between her current and future prospects have further strengthen her unideal idea of marrying a man in the future.

Despite being comfortable with where she was in life, especially romantically, May now had more anxiety being at home, especially talking to someone on the phone for prolonged periods of time, which often prompted her mother into questioning who she was talking to. Therefore, she often had to hide who she was talking to and hide her cellphone in front of her parents. Moreover, for her, meeting her partner became even more risky leading her to construct strategic lies so that her parents remained unaware of her partner’s existence. This ensured no questions were raised nor any suspicions created at home.

May’s mother found out about her previous relationship with women, through an invasion of privacy in the past (“she went through my phone”) and still brings it up to this day, asking if May knew that this “was not right” or still has homosexual feelings. After her mother found out “repeatedly”, she sent May to a Pakistani university, instead of university in America, in hopes that it would be “holier” and “help” her. Her mother believed that no one at her university campus knew, which is “crazy” because most people do. She recalled having to constantly come up with different things to “sell” to her mother to “throw her off the trail”.

May is quick to note that compared to most others, she is rather privileged. Her parents would never take drastic measures if they found out again – but it is not something that would be taken lightly. She feels confined and constantly anxious at home.
“I’m up in a second if someone knocks at my door, because I am so worried”.
Her mother would always assume that talking to someone at night meant romantic involvement, which it would, but in May’s case it would be usually be a girl and her mother started picking up on this pattern. May now, whilst at home, has to be very careful about where she is, who she’s talking to and how she filters her thoughts when talking to her parents. Constantly thinking on her feet and having a backup plan about if she’s “caught” with a girl are persistent fears. She pointed out how emotionally taxing this ordeal becomes and that she can feel a physical sense of heaviness at home.

With objects in particular, she mentioned her phone as something “really really weird”, yet significant towards her identity due all the “secrets” it holds. She always has it on her person, worrying about a girl texting her, or her mom going through it – again.

While discussing coping mechanisms, she mentioned that every time a state of frenzy overtakes her she turns to the drug hashish.
“I try to convince myself that it will calm me down, but it ends up making me think even more”.
Sometimes it helps her achieve a temporary state of complete numbness, but if something goes wrong – internally or externally – thoughts begin backlog, and rush back when she becomes sober again.
“This may be a way for me to tell myself it’s time to stop, but I never do”.
At this point in the pandemic, after being home for more than 6 months, the ritual of getting high becomes almost necessary; she is doing something under her parents’ roof that they would not approve of – an act of defiance that perhaps gives her a boost of confidence under mounds of anxiety.

During the pandemic her younger sister moved into her room and eventually May started video chatting with her significant other in front of her. Fortunately the younger sister was comfortable with the arrangement. It would not “have lasted very long” if she wasn’t, May added. She stated that her family is “very close” and tend to spend a lot of time together in the same room, but she is still privileged enough to have her own room and space. This is why she prefers the nights, when her parents go to bed, knowing she won’t be disturbed by anyone and can talk to whomever she wants.

It becomes a “classic case of family versus you” and your identity, yet she again admits that this is eased because she comes from a place of privilege where her life is “too easy”. Even though she has it “easy” in comparison, for the person going through the circumstances, family not accepting you for who you are can be the “worst thing ever”.

Parisheh

For many members of the queer community, sexual identity is pivotal to their relationship with others and the spaces which they inhabit. For Parisheh*, coming out to herself was a turning point in the way she viewed herself and those around her. Previously, it had felt as if she was “trapped in the wrong body”. To the contrary, she realized it was her external surroundings – a particularly conservative society where homosexuality is a taboo – which were not suited to her. Coming to terms with her queerness has since had ripple effects on what she considers a “safe space”, and the kind of life she has come to live outside of her home.

Presently, she describes the people whom she is closest to as “accepting and loving”. Her choices as a queer individual are respected. They are even willing to learn about things they do not yet fully understand themselves. For Parisheh, this holds great importance. Surrounding herself with people who do not challenge or dispute her sexual identity has, in turn, pushed her to practice kindness with herself.

This was not always the case. She describes previous friendships, talking about how she could’ve “never” come out to them. This realization dawned upon her through the simplest of conversations. It did not feel as if they would fully accept her for the person she is today. Naturally, this led to her seeking out and crafting a more selective space – one where she felt she could have a “safer experience”.

Before having to isolate in her home, Parisheh would attend classes and spend time with her friends in a space that felt open and understanding. They were able to discuss “all kinds of topics”, particularly in relation to her experiences as a queer woman. Having an environment within which she could move about without restrictions was important for her. She spoke of her plans for this academic year before the pandemic hit: “school trips, exhibitions, meeting people and networking with different artists”. While this may seem insignificant, she feels that it would’ve been crucial in “promoting growth” for her mentally and emotionally. This has since taken a backseat over the last few months.

At home, she feels that she can no longer talk about the many aspects of her personal life which she cares deeply about. She has struggled with her “new” reality: being away from people who are familiar with and accepting of her sexuality. She feels that most queer individuals have felt confinement at some point in their lives; whether it be within themselves or with expressing themselves wholly in front of others.

Speaking about her home life, she reveals that her parents have acted as a nurturing presence in her life. This had an undoubtable impact on her relationship with herself: it led her to seek similar influences in her life outside her home. While they are on “good terms” with each other, Parisheh still feels that she has to hide a large part of who she is around them. Matters of sexuality and queerness can not be discussed openly. This is, unfortunately, a reality that much of the country’s queer youth has had to live with. While having to conceal parts of yourself can feel limiting, many LGBTQ+ individuals would be putting themselves in serious harm’s way if they were to live their “truth”. Consequently, finding even the smallest of spaces where one can truly feel like themselves, is considered a victory.

However, Parisheh is hopeful that she can craft this space for herself some time in the near future. She is looking to move out of her parents home and become financially independent.

While quarantine becomes increasingly monotonous and stress-inducing, young queer women like Parisheh face new learning curves on a daily basis. While some grapple with abusive households, others struggle with self expression – and most continue to confine themselves. Finding a radically open and caring support system is rare – but in times of uncertainty, it serves as a steadfast guiding force.

Zara

“A bracelet sent by my partner during lockdown with the coordinates of the first place we kissed.
I wear it everyday, makes the 12000km between us not seem so much”. – Zara

Zara’s first exposure in relation to members of the LGBTQ+ community came in the form of those identifying as transgender. Members of the khwajasira community were and still continue to be ostracized in several different cruel and often inhumane ways in Pakistani society. Zara’s family had a lot of reservations regarding these individuals, “the idea that transgender children were born as a punishment, a saza for their parents really stayed with me growing up”, her tone softening as she speaks of the indoctrination she faced at the hands of her parents. Belonging to an extremely traditional Punjabi family, Zara was fed the conventional heteronormative narrative regarding marriage that many children from desi households are often subject to. Her family – particularly her maternal side’s – deeply embedded homophobia is what has discouraged her from coming out to her family members despite Zara having been certain of her identity as a bisexual woman for 2 years now. In retrospect, Zara recalls feeling attracted to women when she was in 6th grade, but a lack of awareness regarding the LGBTQ+ community or the wide spectrum of identities and orientations that it encompasses meant that she only recognized the attraction for what it was much later on in her life.

While Zara has come out to her friends and is extremely grateful for all the support they’ve received her with, to tell her family about her sexual identity is something she could never even imagine doing. “I want one less problem in my life!”, she exclaims, stating that it would only cause conflict within the household as her religious mother would find a way to blame this on something – the media, or perhaps her father’s side of the family. “It is really triggering for me to see the way my mother reacts to queer people on TV and in the media”, Zara explains, “she calls them disgusting and unnatural, I will never be able to share my space with her because she would never accept me for who I am, she’d kill me…” her voice trails off. Zara doesn’t have a particularly good relationship with either of her parents, she is used to living away from them for long periods of time and thus claims that quarantine has been particularly challenging for her family due to this. She feels as if the frustration has a lot to do with her not being accustomed to their presence for this long, the transition has been difficult given that she also feels the added burden of maintaining a long-distance relationship. Her partner is her biggest support system but time difference and the communication issues they were faced with during the pandemic really made her concerned about the state of their relationship, she was distraught at the prospect of having to be away from them for such a long period of time, going from seeing them every day to talking at odd hours of the night was a difficult change to adjust to. Zara’s bedroom is her safe space and though her parents give her plenty of privacy, she yearns for familial support and comfort especially when dealing with anxiety which she is prone to and was further exacerbated during periods of confinement during the pandemic.

Zara speaks at length about the various different ways in which she has been made to feel as if her identity is invalid, both within the LGBTQ+ community and outside of it. Despite having many friends belonging to the community, she remarks upon how many queer people often dismiss her bisexuality claiming that “it’s just not a thing”. She’s upset and disheartened by how people who have often been through similar struggles are so quick to invalidate her own. Many times, straight men have dismissed Zara’s sexuality in a similar manner by claiming that it is “just a phase” and that she’s “confused and will eventually come around”. This dismissal of an integral part of who she is becomes even more apparent when Zara finds herself in a relationship with a male. Though her current partner is extremely accepting and encouraging of her identity, she has felt confined in situations with men who refuse to accept her bisexuality as being real and valid. “It’s extremely necessary to find a supportive partner that can give you the space to explore your sexuality comfortably”.

Zara also relays to me her frustration regarding ‘cishet’ men – cisgender heterosexuals – who fetishize her identity, often sending her unsolicited messages or propositioning threesomes simply making assumptions that she would be interested based on the fact that she’s bisexual. “A threesome with two women is the ultimate male fantasy”, to Zara participating in such a situation has to be based on consent rather than an assumption about a woman’s sexuality. It is demeaning to see her sexuality debased in this way to cater solely to the pleasure of men.

Zulfiqar

Zulfiqar Mannan, or Zulfi, is a Pakistani musician and poet. They can be found on Instagram or Twitter, and are passionate about gender politics, human rights, and romanticizing their life.

To live is to experience life in all its abundance, to give yourself away to experiences, and to allow them to deeply affect you. I listen to Zulfiqar as they weaves tales of their city, Lahore, and of moments that flooded them with feeling, grounding them while whisking them away. They speak of the creativity this attention to detail granted them, the blooming romance of understanding where they resided rather than being used to it. By regaining their connection to their city, I understood they were gaining back their sense of identity, able to figure out where they belong and thus finding the space to access new forms of caring and rationalizing in their life.

A Yale student in their final year, Zulfiqar experienced the shutdown of New York firsthand. Living with their partner in the city, they found their productivity and joy had ebbed away, so consumed were they by the exhaustion of the dual labor of performing as a brown, non-binary body while maintaining the diaspora that made them acceptable to those around them.

“There was a simple evil in front of me,” they explained in a rushed sort of way, as if this release was required. “America – a lot of my life there was reactionary, full of snarky remarks and criticism for those who were wasting away their lives here, all privileged, first world individuals who considered themselves revolutionaries. The full face of hypocrisy was hearing them call themselves queer right activists, and yet lose themselves in the same consumptions patterns and complicity they were so against.”

They paused here. “It’s hard to interact empathetically with people who consume while complaining, I guess. It lacks honestly.”

Such influences trapped Zulfiqar in a pattern of indulgence, subjecting them to a declining phase of mental health. It is for these reasons that the oncoming pandemic acted as a wakeup call for them. While lockdown shut down lives, it awakened theirs. They rushed back to Pakistan, united with family once more. For them, it felt surreal, mystical, as if all the pieces were finally fitting. It is then that they were introduced to the experience of Lahore as their hometown, and they entered a phase of homecoming.

“I had never experienced air this clear and skies so blue,” they shared in wonder. Their tone took an ecstatic note as they relayed the magic of Lahore to me, one free of the exploitation of nature, one where they found the birth of their romance for Pakistan. “It was when I took a walk around my suburbs that I knew. The weather was the nicest it had been, and I decided to leave without my keys, without a wallet or phone and walk endlessly. There, I discovered new trees I had not seen before, park I hadn’t card to notice and areas that were unexplored. There was one area I trespassed into, a lowly settlement whose wall was broken from one side. There was no one to stop me from going and entering this new world, an area of exploration. I felt positively darveshi.”

This freedom and acceptance did not come from a vacuum. The years it took to shape Zulfiqar’s perception of themselves and lead them to this period of their life took their time. Their life In Pakistan before college, to them, was marked by their dissatisfaction. There was a distinct absence of connection to Pakistani culture, one they felt was owed to their queerness. Even within a luxurious house and with their friends, they continuously felt misunderstood, new anxieties being born every day, suffocating them within this metaphorical cage. It was this American exposure, it seemed, that allowed them to accept their own identity and find the footing to function as a queer body. Without tapping into your identity, there are certain streams of philosophical work that cannot be accessed. Without the truths they found concerning their identity and who they were, they would not have been able to experience their country as they did now, basking in its beauty with their identity reaffirmed.

Zulfiqar recounted a story to me, one about a young person who looked into the mirror and did not see themselves. They could not reconcile with this stranger they viewed, one who did not have the desired features that years of whitewashing and conditioning had instilled in them as desirable. On a trip to France, they had had a caricature drawn of them, one whose European features permeated their Desi ones, and thus, they confronted the face they had been seeing in the mirror all these years. This realization was incredibly important to them, making them see how they treated parts of themselves with the same racist disrespect they hated from others. “No more will I be unkind to brown babies,” they told me, triumphant at this realization. No more will they be unkind to themselves.

With this certainty of identity, there is room for new dimensions of creativity to be reached than ever before. “I was in a weird, gardenesque mindset,” Zulfiqar explained. “I was flooded by this need to regain my Punjabi heritage, focusing on the language in ways that weren’t accessible in America. Here, I could ask my mom for meanings of words I don’t know. I could read Parveen Shah poems immediately, just by ordering a book. There was nothing to stop me. Now, I can safely and confidently say that I have felt my creativity has been restored, one that had been previously sapped in the other world. I could see art more clearly.”

Life began to change drastically. Creation began to take root in newer ways. They found themselves seeking newer relationships, beginning a small romance over the messaging app Whatsapp, proclaiming it to be ‘Whatsapp ishq’ – after flirting with this ‘sexy, straight boy’ they would drop them as quickly. Another channel was that of growth – they started to work on their terrace, a previously abandoned area of their house. Entering a new phase of quarantine, they set their minds on refurbishing it, converting an old bed to a jhoola. Suddenly, they would enjoy sunrises and sunsets next to lovely green plants they would then water. This kind of energy was something unexperienced before, this creation of life within one’s own home. Unlocking one’s femininity through the act of nurturing promoted them to look at the things around them with love and desire, finding loveliness in the mundane. This gave way to reimagining the way they saw things previously, confronting their privilege to allow for a wider space of growth.

Zulfiqar confided in me that initially, they had come to undermine and deny their trans identity, finding it difficult to exist in a Pakistani heterosexual mentality, but halfway through, discovered their sister’s old tops. These sleeveless clothes not only asserted their presence to their mother, announcing that they are still the person they always were, but was an important breakthrough for ideas and notions of space. There was room, they discovered, to exist as a non-binary body in Pakistan, places they can go incognito. There was a lack of pressure of the need to have an ‘in-your-face’ queer liberation, and they found themselves content with wearing their jhumkas and crop tops at a friends house.

“I allowed myself to access this freedom in private places,” they shared. “In Pakistani public life, they don’t really want ideas of sex to come out. For me, I just believe people don’t deserve to have access to you more than you want them to.”

For Zulfiqar, existing as a trans person in Pakistan allows you to be much more honest with your own identity. “I was working in a ration drive and met a person who was assigned male at birth but identified as female. They had moved cities on their own, finding an apartment to live in while contributing and helping those around them.” They had a tone of surprise, but one that was tinged with the knowledge that the differences between rights in the first and third world could be so stark. “Brown trans people in New York lack that comfort with their identity, I think. They are overly conscious and its harder to connect with them. Trans joy, it seems, is completely different in Pakistan.”

To have this sort of reassessment and connection to their identity, Zulfiqar first had to allow the permeation of confronting uncomfortable truths about the way they viewed themselves, unlearn them, and then be able to function as a queer Desi body. Its important to note the unconscious ways we are designed to hate ourselves and subject our own bodies to scrutiny, ways we must unlearn to unlock peace with our identities.

Bibliography

Dasgupta, Rohit K. 2017. Digital queer cultures in India : politics, intimacies and belonging. London: Routledge. Accessed May 18, 2020.

Dave, Naisargi. 2012. Queer Activism in India: A Story in the Anthropology of Ethics. Durham: Duke University Press. Accessed May 18, 2020.

Foucault, Michel, Michel Foucault, Michel Foucault, and Michel Foucault. 1978. The History of Sexuality. New York: Pantheon Books. Accessed May 18, 2020.

Watch, Human Rights. 2013. This Alien Legacy: The Origins of "Sodomy" Laws in British Colonialism. London: University of London Press. Accessed May 18, 2020.

Parchhayian

By Amna Rauf, Kanza Hussan, Huda Mehdi Shah, Zilehuma

Introduction

Parchhayian is a collective effort of four femmes from the Lahore University of Management Sciences. This ethnography focuses on the queer artistic expression and how it has been revolutionized under the circumstances of isolation wrought by the coronavirus pandemic.

Queer identities, particularly in South Asia, have a marginalized status and face severe social ostracization. A significant way through which queer individuals express their collective repression is through creativity form. In an era of online mediated platforms, we have come to visualize the queer community articulating their suppressed sexual and gender identities through the presenting of their art on social media. Our ethnographic research project aims to exhibit an anthology of literary/visual/performing arts by our queer informants.

In the wake of the recent pandemic, with queer individuals in Pakistan living in fragmented, oppressive patriarchal structures, our research unfolds the ways through which their variant art is expressed, through altered mediums. We have provided a visual and holistic experience of how our queer informants have adapted to the lack of access to physical safe space emulate some semblances of their selves through online social platforms. Finally, we recognize how producing art and expressing it through social media has served as a coping mechanism for queer youth in Pakistan.

Our ethnography has taken inspiration from our participant’s artistic capabilities in a synchronized narrative storytelling experience. We have covered extensive interviews with six queer Muslim artists from all around the world. Our qualitative data collection from our interviewees varies from poetry, prose to art pieces and illustrations. We hope to have provided these individuals with the much-needed spotlight to explore any details that are crucial to their queer experience. Our methodology for interviews was both: in person meetings and zoom video calls. Parchhayian incorporates excerpts from the interviews in the form of dialogues, artwork, handmade illustrations and collages inspired by each artist's definitive journey. Our research maintains research ethics- upholding confidentiality and has been cognizant of our participant’s comfort and needs.

We laughed, cried, had some awkward moments and ultimately transformed through the wonderful experiences we had over the past month. We worked hard on Parchhayian, nursing it from an abstract concept to the journal you hold in your hands today. Special thanks to the talented @lil_fresh_vibe for the wonderful cover of our journal. Check her out! Also, to all our informants-turned-friends: this project would never have been possible without your time, energies and sharing details about your life that are not easy to say the least. We hope you enjoy Parchhayian as much as we enjoyed curating it. Thank you for your support.

With love,

Team Parchhayian

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The Gendered Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Workers in Pakistan

By Hira Farooq, Rida Fatima, Zainab Farooq, Zumer Zia

Abstract

This paper aims to explore the impacts of the COVID-19 pandemic on the mental health of healthcare workers in Pakistan through a gendered lens, delving into the question of whether the mental health impacts differ for male and female healthcare workers. There is some evidence in existing research that supports the hypothesis that a difference exists. A study in China, as well as a study in Pakistan, showed that female healthcare workers experienced higher levels and more severe symptoms of depression and anxiety as compared to men. Female doctors, particularly, have experienced a worsening of the “triple burden” with intensification of productive, reproductive and community work during the pandemic, as was observed in Sri Lanka, Vietnam, Malaysia and Australia. Our study consisted of carrying out semi- structured interviews as well as conducting an online survey which incorporated the DASS-21 questionnaire. The mean scores for Stress, Anxiety and Depression were all in the normal to mild range, however, the means for females were greater as compared to males for all three. This suggests that, albeit small, there was indeed a difference between the experiences of male and female healthcare workers, with them being particularly affected by depression. Issues such as long working hours, fear of contracting the virus, witnessing high levels of death, lack of patient compliance and harassment in hospitals were common among doctors irrespective of their gender. However, the pandemic inevitably resulted in an increase in domestic responsibilities for females, especially married ones. Similarly, males who are often burdened with financial responsibilities, suffered due to reduction in salaries and delayed payments. This allowed us to conclude that a detailed psychological intervention plan is necessary for the alleviation of mental health symptoms caused by disasters like the Covid-19 pandemic.

Introduction

On the 30th of January, 2020, The World Health Organization (WHO) declared the novel coronavirus outbreak as a public health emergency of international concern (PHEIC), the highest degree of alarm¹. Pakistan reported its first two cases of coronavirus on the 26th of February, 2020, in Karachi, both of which had been imported from Iran². With its first locally transmitted case being reported on the 13th of March, 2020³, Pakistan subsequently experienced an exponential rise in cases, the peak of which was witnessed in the early days of June when the daily number of reported cases reached up till around 6000 cases a day⁴. Pakistan, a country with a population of around 213 million, had poor pandemic preparedness. With 963 people per doctor, 1962 people per nurse and 1608 people per hospital bed⁵, along with 0.32 ICU beds per 100,000 people and 1 ventilator per 100,000 people⁶, Pakistan’s weak and fragile healthcare infrastructure experienced a severe overburden, exposing the glaring reality of a system that has been underfunded, understaffed and under-equipped over the years. Not only has the COVID-19 pandemic led to a greater physical burden of excessive working hours for healthcare workers all over the world, but it has also resulted in psychological impacts and deterioration of their mental health⁷.

This paper contributes to existing research by taking a nuanced approach to the issue of mental health of healthcare workers by examining the impacts through a gendered lens to determine whether male and female healthcare workers experience differential levels of stress, anxiety and depression, and whether the reasons for these aggravated levels differ across the gender. There is some evidence in existing literature that supports the hypothesis that a difference exists. A study in China⁸, as well as a study in Pakistan⁹, showed that female healthcare workers experienced higher levels and more severe symptoms of depression and anxiety as compared to men. Female doctors, particularly, have experienced a worsening of the “triple burden” during the pandemic, which refers to the handling of productive, reproductive and community work, as was observed in Sri Lanka, Vietnam, Malaysia and Australia¹⁰.

Studies have shown that even under regular circumstances, healthcare workers experience a greater amount of stress than people from other professions, aggravating both mental and physical health problems¹¹. During a public health emergency, healthcare services are placed under extreme pressure, augmenting the existing high levels of stress that healthcare workers already face¹². The COVID-19 pandemic has been particularly strenuous on healthcare systems around the world, given that the disease is highly infectious and can result in the requirement of critical care for patients of all age groups, although the elderly are on average more likely to become seriously ill by the disease. Reasons that can be associated with the additional levels of stress include the high risk of infection for healthcare professionals, particularly those at the front line of diagnosis, treatment and care of COVID-19 patients, shortage of personal protective equipment (PPE), and the fear of transmission of the virus to their families¹³. Additional reasons for stress and anxiety include factors like being responsible for diagnosis and treatment of patients in a situation of shortages of healthcare equipment and facilities, witnessing high numbers of deaths and excessive fatigue due to long working hours¹⁴. Adverse mental health impacts on healthcare workers were also reported during previous pandemics, such as the SARS outbreak (2003), MERS outbreak (2012) and the Ebola outbreaks in West Africa, including experiences of trauma that lasted for months and even resulted in suicide in some cases¹⁵. With regards to the novel coronavirus pandemic, research is gradually emerging which provides insight into the mental health decline and high stress, depression and anxiety levels for healthcare workers all over the world, including China¹⁶, Europe¹⁷ and even Pakistan¹⁸.

The question of mental health is extremely important to explore, particularly from a gender perspective, as mental health is a key aspect of the wellbeing of individuals. Moreover, healthcare professionals are performing the most key role in the pandemic by diagnosing, treating and caring for patients. Hence, their mental and physical wellbeing is essential to enable the healthcare system to function properly. Moreover, not only do women comprise 70% of the frontline healthcare workforce battling against Covid-19 globally, females are also disproportionately being impacted psychologically by the pandemic and it is crucial that their mental health is cared for¹⁹. The World Health Organization has also identified the need to look after one’s mental health during the pandemic under the Sustainable Development Goals - Goal 3: Good Health and Well Being, particularly for health workers, and has issued guidelines and advice on the matter²⁰. Not only do health workers suffer from greater stress, they also struggle in reaching out to others and seeking professional help particularly because of the immense stigma surrounding the subject matter²¹. Stigma surrounding mental health is worse for health workers as mental health problems are perceived to be an indication of professional incompetence, endangering their careers due to potential license restrictions and being deemed unfit for practice²². It is, thus, essential, that some policy mechanism be created to address the issue of mental health of health workers, particularly exploring the need for a gender-sensitive policy intervention that is cognizant of any gender- based differences that may exist in mental health impacts and their associated reasons.

This paper will use a combination of a qualitative and quantitative approach to examine the levels of depression, anxiety and stress for male and female health workers in Pakistan, assessing whether a difference exists with regards to these levels and their associated reasons across genders. It will first explain the methodology of the study, followed by the limitations. It will then go on to explain the quantitative results, including statistics pertaining to the sample, depression, anxiety and stress levels, gender differential, effect of being on the frontline, and reasons for elevated stress levels. It will then have a discussion of the qualitative results, followed by policy recommendations and a conclusion.

Methodology

Our approach consisted of a cross-sectional observational study which was conducted within a month and divided over two phases. The first phase of our study involved conducting an online survey which included a pool of 102 participants using a non-probability snowball sampling technique. Our respondents were primarily doctors with 81% of the female and 92.31% of the male respondents operating in Punjab. Inferring from a similar study carried out in Karachi^[23], our online survey consisted of 5 parts; this involved a consent agreement to ensure voluntary participation of our respondents, demographic data, DASS-21 questionnaire, reasons for stress and lastly a section on mental health aid.

In order to observe the relationship between gender groups (Male and Female) and their DASS- 21 score in a more nuanced manner, the demographic data included marital status, age, number of children, age of the youngest child and respondents’ involvement in treating COVID-19 patients. In addition to this, incorporating the DASS-21 questionnaire served as a measuring tool to assess the mental health of participants in the context of experiencing depression, anxiety and stress. Furthermore, based on literature review, we provided a set of potential reasons for stress experienced by respondents to choose from and asked them to provide us with their preferred method of seeking mental health aid by choosing from a list of predetermined options.

Depression, Anxiety and Stress Survey (DASS)

The DASS is a set of three self-report scales designed to measure the negative emotional states of depression, anxiety and stress. The DASS-21 questionnaire is available online and serves to provide a convenient set of scales to measure clinically significant emotional states usually described as depression, anxiety and stress²⁴

It plays a significant role particularly in our research as its relevance is two-fold; firstly, DASS surveys have been used in similar studies pertaining to assessing the mental health of frontline workers within existing literature²³. Secondly, not only is the DASS-21 questionnaire more practical, as it requires only half the time to administer compared to a standard DASS questionnaire, but also can be solely administered online which further facilitates our online survey as scoring can be automated ²⁴.

In addition to this, using the DASS-21 questionnaire assesses a relatively specific syndrome of tension that is narrower than the conventional conception of stress. This allows for a more nuanced assessment of participants’ mental health as all three DASS scales (i.e. Depression, Anxiety and Stress) are relevant to the assessment of stress in the broader sense²⁵.In the second phase of the study, the research team carried out 18 semi-structured interviews over phone and WhatsApp calls. The duration of each interview was approximately 10 minutes and the interviewees were selected through our contact circles and social media. Instagram and Facebook groups like `Corona Recovered Warriors` were particularly useful in getting contacts from doctors. 11 of the interviewees were below the age of 30 and 7 were 30 and above. Out of the 18 individuals, 13 were male and 5 were female. 6 people were married while 12 were unmarried. Most of the interviewees were employed in the public sector, with only 3 associated with the private sector. All the above-mentioned individuals were involved in the diagnosis, treatment or care of COVID-19 patients, directly or indirectly. The vast majority of the interviewees were doctors, with 2 being part of hospital administration staff.

Limitations

Given the lockdown and health concerns prevailing due to the pandemic, the sampling technique used in this research involved the use of social media as a tool to approach health workers, as well as the use of snowball sampling whereby close associates were approached and asked to pass on the survey to people, they knew. This resulted in the sample not being exhaustive or entirely representative of the population, class and region. The majority of respondents were doctors from Punjab, with the perspective of paramedics and administrative staff, and healthcare staff from Sindh and Balochistan, being largely unrecorded. It is possible that a wider sample, especially one that is more representative of paramedic staff from lower economic backgrounds, could have given us representative results. Yet, despite its limitations, this sampling technique gave us important insights because Punjab has been the second most affected province of the country and experienced severe healthcare overburden during the peak of the pandemic; experiences of doctors from this province are crucial for an understanding of what the mental health condition of doctors Pakistan-wide is likely to be.

Moreover, the limitations of this research involve some of the limitations of the DASS-21 questionnaire itself. The DASS-21 questionnaire is mostly based on individual-centric questions and is designed from a Western-society perspective, hence, is considered less valid for Asian societies. A study depicted that Asian societies are oriented more towards collective goals rather than individual goals, and so, stress is often associated more with concern for others rather than oneself. These differing cultural values also impact how individuals experience, perceive and express their emotions, including emotions pertaining to depression, anxiety and stress. This means that a standard scale for the measurement of depression, anxiety and stress may not be entirely accurate²⁶. Almost all of the individuals interviewed emphasized that the primary reason for stress was fear of infecting others and most of them highlighted that they were not concerned about their own selves, thus depicting the aspect cultural gap as explained above. Despite this, the use of the standard DASS-21 was preferred because it helps make our study more easily comparable to other similar studies that used this survey, for instance the studies in China²⁷ and the study in Karachi, Pakistan²⁸.

Additionally, respondents were asked to answer the questions on depression, stress and anxiety based on their experiences during the peak of the pandemic, which was seen during the early weeks of June. The problem with retrospective recalling of stress-related symptoms is that the recalling may not entirely be accurate. When respondents were filling out the survey, the COVID-19 cases had gone down considerably, and were on the course of decreasing further²⁹. Thus, this would affect any pandemic- related stress that we are trying to gauge.

Quantitative Results

Sample

Out of 102 participants, there was an almost equal division of men and women with 52 males and 50 females³⁰. The majority of the respondents were young with 35 in the 18-25 age bracket and 56 in the 25-35 range. 60.8% of the respondents were unmarried with only 40 participants (39.2%) being married. The bulk of the healthcare workers (76.5%) did not have children while 23.5% did. In addition to this, 89 (87.3%) respondents were operating in the region of Punjab out of which 65 (73%) were employed in the public sector. 98% of the pool of respondents consisted of doctors while only 2 individuals belonged to other arenas of the healthcare sector. 70 out of the 102 individuals surveyed were directly involved in the diagnosis, treatment, or care of COVID-19 patients, thus being categorized as frontline workers.

Depression, Anxiety and Stress Levels

When we look at the scores of our respondents in the DASS survey, as shown Table 1, we can observe that 31 (30.39%) participants were experiencing moderate to extremely severe levels of depression. Similarly, 13 (12.75%) participants experienced moderate to extremely severe levels of anxiety and 12 (11.76%) experienced moderate to severe levels of stress. As shown in Figure 1.1, the mean score for Depression was 5.1 with male and female mean scores being 4.7 and 5.6 respectively. The mean of the Anxiety score was 3.1 overall; the Anxiety mean for males was 2.7 and 3.5 for female healthcare workers. Lastly, the overall mean for the Stress score was 4.6, with the male and female average being 4.3 and 5.0 respectively (Figure 1).

Out of the respondents experiencing moderate to extremely severe levels of depression, 17(16.67%) were female doctors and 5 (4.9%) were married female doctors. 3(2.9%) female doctors were directly involved in treating COVID-19 cases. The mean scores for Stress, Anxiety and Depression are all in the normal to mild range, however, the means for females are greater as compared to males for all three. This suggests that, albeit small, there was indeed a difference between the experiences of male and female healthcare workers, with them being particularly affected by depression.

Figure 1

Figure 1.1

Qualitative Results

Reasons for Depression, Stress and Anxiety

There were various reasons for stress during the pandemic and the respondents were given a list of potential reasons, from which they were required to select the three most relevant. They were also asked to elaborate upon these in the interviews. This was done in an attempt to (a) gain a deeper insight into the issues healthcare workers are faced with and (b) understand if the reasons vary with regards to gender. The three most common reasons for stress irrespective of gender, were as follows:

Long working hours and excessive fatigue: The healthcare personnel related that there was extreme patient load at most hospitals during the peak of the outbreak, which resulted in doctors being overworked. The working hours of all had increased significantly with minimal breaks between the next shifts.

”I worked 12 hours at a time, went to my hostel, slept and returned to the hospital again. Life had become very limited”.

“My duty hours were extremely long. Every third day, I had to be at the hospital from 8am to 3pm the next day.
I was also expected to do long weekend duties and was working on Eid day as well.
This was a cause of extreme stress for me.”

Fear of transmitting the virus to your family: All of the individuals interviewed were living apart from their families in hostels, or were isolating themselves in separate rooms, for fear of infecting elderly parents or children. Many recounted that they took particular care to shower and disinfect themselves before coming into contact with their families. This also resulted in many not being able to meet their families for long periods of time which proved to be a constant source of stress for them.

“My family resides in Rawalpindi and I am working in CMH Lahore. Due to fear of infecting them, I have not gone home in the past four months.
I am also getting tested for COVID-19 every week.”

“This was a pandemic and I was very scared that if I got the virus my family would get it too...
I could not meet my family during working hours. Also, we had to fulfill a compulsory
incubation period of 3-15 days during which meeting family was not possible.
Hence it was a very difficult time for all of us”

Lack of patient compliance: Almost all of the doctors related that patients refused to follow SOPs as they did not realize the severity of the situation, especially at the start. Many believed that the pandemic was not real and accused the doctors of killing patients, believing in the false news and misinformation that was rampant.

“We had to work hard to make the patients accept that they had Covid-19. They were in denial.
They often argued that we cannot get the virus. We had to convince them to get treatment.
They asked us to give them some medicine so they could take it and go home.
We had to face this issue a lot as doctors. This often caused me to become
irritated and we came to a point where we felt like telling
the patients to do as they wanted”

Patients behaved aggressively when they were quarantined or asked to wear masks. Many doctors were at the receiving end of violent behavior by infected individuals and the general public.

“Once a patient had a tumor for 6 months. His family did not bring him to hospital due to Covid-19 and
when they brought him, he passed away. Then they blamed us doctors entirely for
not treating the patient properly and got violent with us.”

“When patients would get isolated, they would demand to go home and respond with aggressiveness.
People did not follow SOPs and would come into emergency without masks.
When they were asked to go out and get masks, they would get angry.
Also, there was a general perception that COVID-19 is not real,
and doctors are giving a `zehar ka teeka` (injection of poison) to patients”

The Different Experiences of Male and Female Healthcare Workers

On the surface level, it seems that the experiences of male and female healthcare workers were not too different. Issues such as long working hours, lack of patient compliance and fear of transmitting the virus to one’s family were common among the respondents irrespective of their gender, as evident in Figure 2. When asked in the interviews whether their experiences as healthcare workers were different based on their gender, 10 out of 17 respondents said that they felt no such difference and everyone was faced with the same issues with regards to fear of contracting the virus and lack of protective equipment.

“Personally, I felt that we were all in this together, we all were frontline warriors.
We had same duties and same working hours and there was no discrimination.”

However, this emphasis on similar experiences of males and females was not always the case. Some doctors expounded upon the unique experiences of their female, married colleagues and

how they faced increased stress levels due to domestic and childcare responsibilities as well as pressure to leave their jobs for fear of contracting the virus. Of the 9 respondents who chose increased child care responsibilities as a cause for their stress, none of them were males, showing how intensification of domestic burden during the pandemic was true primarily for females, specifically married ones(Figure 2.1). This was largely due to the closure of schools and the lack of availability of domestic help. As one of the interviewees pointed out:

“It was very hard being a frontline worker as well as managing home responsibilities along with the lockdown.
I had to look after my kids as well and due to the lockdown maids were also not coming.
I had to manage everything at home myself…”

These increased child care responsibilities represent the `triple burden` women are faced with and demonstrate how women's reproductive burdens have been perpetuated, reinforced and increased in the context of this pandemic ^[22]. The following interview excerpts reflect the difficulties married female doctors faced.

“As every doctor, I had to follow precautions and sanitize myself before looking after the kids or
cooking so this became an added time-consuming chore”.

“My married colleagues were more stressed as they were concerned about their children,
especially breastfeeding mothers. Males, on the other hand,
were generally more carefree and took less precautions.”

“I think females were affected in a sense that it was not possible for many of them to leave their homes or continue practice.
One of my female colleagues resigned saying that she could not come and it didn’t matter if she had to resign.
Males were usually not that conscious or faced any such issue and continued their duties”

“Married female doctors face a lot of pressure from their partners. They are often married to non-health
professionals such as lawyers. These people have less awareness. They ask their
wives to sit at home rather than going to the hospital and bringing home the virus.”

Similarly, of the 10 people who chose financial difficulties as an option, 7 were males. This was often due to delayed payment of salaries during the pandemic.

“Instead of increasing our salaries due to increased workload, they cut our salaries and we were also paid very late”

Similarly, a female doctor pointed out this issue and said:

“I received my pay now after 5 months. But this was not stressful for me as my family supports me,
however, it was a cause for concern for those with financial responsibilities”.

All in all, we understand that issues such as long working hours, fear of contracting the virus, witnessing high levels of death, lack of patient compliance and harassment in hospitals were common among doctors irrespective of their gender. However, the pandemic inevitably resulted in an increase in domestic responsibilities for females, especially married ones. Similarly, males who are burdened with financial responsibilities suffered due to reduction in salaries and delayed payments. One may argue that this finding is not representative of the entire population as our pool of interviewees included only two married, female doctors and they incorporated these factors as triggers of stress in their responses. For this reason, more interviews of individuals belonging to this demographic need to be conducted to gain a more nuanced perspective.

Figure 2

Figure 2.1

Policy Recommendations

While many national standard operating procedures (SOPs) and crisis management plans place a lot of emphasis on physical health, there is an urgent need to bring mental health under their domain. Out of the doctors surveyed, only 7% sought help from a mental health professional. These low levels of access to mental health are partly because of two reasons:

Only 14.6% hospitals in our sample provided mental health assistance to healthcare workers during the crisis. This remains an important indicator of the unprecedented burden that hospitals were faced with given the lack of human and financial resources and personal protective equipment (PPE) as well as the secondary nature of mental health care in situations such as a pandemic.
When asked if there is a stigma associated with seeking mental health assistance among healthcare workers, 80.6% of the respondents replied in affirmative. This explains the hesitance healthcare workers feel when seeking psychological help as well as the lack of importance placed on mental health issues among the population in general.

In order for the effective provision of mental health services and countering of the stigma associated with it, mental health needs to be prioritized as an agenda in medical colleges and universities as well as within hospital administration. Healthcare workers should have access to a 24/7 hotline through which they can seek help of a mental health professional. The hotline can be kept anonymous so that healthcare workers can reach out without feeling hesitant, especially given the magnitude of stigma that surrounds seeking mental health help among healthcare workers. However, this is only an ancillary method and cannot be used as a substitute for the presence of an in-person mental health professional. Out of the respondents, 73.8% people believe that an in-person presence of a mental health professional is the best option while only 21.4% and 24.3% believe that 24/7 emergency hotline and online therapy are the best option, respectively (Figure 3). Hospitals should devise a detailed crisis psychological support plan that inculcates these methods depending on the availability of resources.

Figure 3

Additionally, it is important that the root causes of mental health triggers are addressed. Despite the overload on the healthcare infrastructure, the government should take measures to ensure that there is an adequate supply of personal protective equipment (PPE) for all healthcare workers, closely addressing the demand and supply and making arrangements accordingly. Since frontline medical workers are the backbone of the Covid-19 response, it is essential that their physical and mental health is catered to. Their

working hours should be properly defined and any time overworked should be appropriately remunerated. Medical staff can be appointed on duty through a rotation cycle, ensuring that they receive adequate rest as well as time to quarantine and overcome any physical symptoms they may be showing as a result of the virus. Health and healthcare infrastructure need to be prioritized in the state agenda and budget allocation as a whole, and the pandemic offers an eye-opening crisis point for the government to abandon path dependency and reallocate a larger share of resources to this crucial sector of development.

Moreover, it is also important to prioritize the well-being of female doctors given the social and domestic issues that they face. While tackling these issues requires a broader change in societal attitudes towards female employment, some arrangements can be made to reduce the `dual burden` that female professionals are faced with, such as provision of safe places with proper facilities for female doctors to isolate after duty in Covid-19 wards and rest in hospitals. Moreover, it must be made mandatory for facilities such as daycares to remain open for the ease of employed women, ideally in hospitals as well. Such services are closed down since they are not considered an essential service.

On a higher level, there is a need for females to be included in the decision-making process. Among the many concerns with regards to health, safety and economy during a pandemic, it is very easy for the voices of women to go unheard. Interpersonal, societal and policy responses to the Covid-19 pandemic have not been sufficiently considerate of gender, meaning that strategic political responses are needed that include women in the development of disaster responses, the control of resources and in the decision- making of matters affecting them³¹.

Conclusion

Existing literature has proven that the mental health of healthcare workers has been significantly compromised due to the Covid-19 pandemic. This research basically aims to add on to this literature by seeing whether this impact has been different for male and female healthcare workers in Pakistan. For this purpose, we carried out a survey of 102 respondents and 18 semi-structured interviews. To gauge the impact on mental health, we used the standard Dass-21 questionnaire which yields Depression, Anxiety and Stress Scores.

On average, female mean scores for depression, anxiety and stress have been higher compared to those for males. One group that has been particularly affected the most among healthcare workers is that of married female doctors, as they experience an increase in domestic responsibilities as well as pressure from homes to quit their jobs for the fear of contracting/transmitting the virus. This particular gender dimension became clearer within the interviews. Majority of the respondents argued that there was no difference in the experiences of males and females professionally; both had same working hours and duties. However, they also described how many female doctors, especially married ones had faced difficulties with child-rearing and taking care of their homes which became further difficult within the context of lockdown. Similarly, male healthcare workers were more likely to face financial difficulties due to reduced salaries and delayed payments. Overall, the most common issues among doctors involved long working hours and excessive fatigue, lack of patient compliance and the fear of transmitting the virus to the family. These reasons remained the most popular causes for stress irrespective of gender.

These slight nuances of the differences between the experiences of male and female healthcare workers allow us to form a better understanding of the plight of healthcare workers during a pandemic and must go a long way in informing the way policies and national crisis management plans are prepared. On first priority, healthcare workers must be ensured supply of basic protective equipment and should be allowed shorter working hours with rapid shift rotations. Moreover, their mental health should be prioritized, which first requires that the stigma that surrounds mental health among healthcare workers be dealt with. Doctors should be provided free or discounted mental health access preferably in the presence of a mental health professional within the hospital, especially among crisis situations such as a pandemic and must be encouraged to do so. While a lot of the issues females face have a lot to do with the larger societal attitudes that stigmatize woman employment, a set of systematic changes need to be brought that prioritize the welfare of females. Essential services such as daycares and female hostels must be kept open to facilitate female doctors. Moreover, there is a need to involve them on national policy-making level to ensure that their voices do not go unheard.

All in all, healthcare workers remain one of the most vulnerable groups that have been impacted by the pandemic. While formulating policies to alleviate their issues, their mental health must be prioritized and the slight differences between the experiences of male and female healthcare workers need to be accounted for.

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Appendix I

Sample Statistics

Figure I.1: Gender

Figure I.2: Age

Figure I.3: Marital Status

Figure I.4: Children

Figure I.5: Number of Children

Figure I.6: Youngest Child’s Age

Figure I.7: Professional Designation

Figure I.8: Public/Private Sector Employment

Figure I.9: Involvement at the Frontline

Figure I.10: Regional Affiliation

Appendix II

Mental Health Help

Figure II.1: Changes in Stress Levels

Figure II.2: Seeking Professional Mental Health Help

Figure II.3: Provision of Mental Health Help

Figure II.4: Did Hospitals Provide Mental Health Facilities

Figure II.5: Mental Health Stigma

Foot Notes

¹Timeline - WHO’s COVID-19 Response, World Health Organization, https://www.who.int/emergencies/diseases/novel- coronavirus-2019/interactive-timeline?gclid=CjwKCAjwkJj6BRA- EiwA0ZVPVl20g7nhSZu5bjjnUpy7X0zZDuix0XETrjNgNQ2ZZqazecYx1y12dxoC4iQQAvD_BwE#event-42.

²Sameer Mandhro. (2020, March 13). First locally transmitted coronavirus case emerges in Karachi. Retrieved from https://tribune.com.pk/story/2175648/first-locally-transmitted-coronavirus-case-emerges-karachi https://www.pakistantoday.com.pk/2020/02/26/sindh-health-two-coronavirus-cases-confirmed-in-pakistan-confirms-first- coronavirus-case-in-karachi/

³Ariba Shahid. (2020, February 27). Two coronavirus cases confirmed in Pakistan. Retrieved from https://www.pakistantoday.com.pk/2020/02/26/sindh-health-two-coronavirus-cases-confirmed-in-pakistan-confirms-first- coronavirus-case-in-karachi/

⁴Government of Pakistan, COVID-19 Official Portal, http://covid.gov.pk/stats/pakistan.

⁵Noreen N, Dil S, Niazi S.U.K, Naveed I, Khan N.U, Khan F.K, Tabbasum S & Kumar D. Coronavirus disease (COVID-19) Pandemic and Pakistan; Limitations and Gaps. Global Biosecurity, 2020; 1(3).

⁶Hassan Javid, Sameen M. Ali, and Umair Javed, “Factional Federalism, State Capacity, and Fiscal Constraints: Pakistan's COVID-19 Challenges,” South Asia @ LSE (LSE, April 23, 2020), https://blogs.lse.ac.uk/southasia/2020/04/03/factional- federalism-state-capacity-and-fiscal-constraints-pakistans-covid-19-challenges/.

⁷ Niall Galbraith et al., “The Mental Health of Doctors during the COVID-19 Pandemic,” BJPsych Bulletin , April 24, 2020, https://doi.org/10.1192/bjb.2020.44.

⁸ Jianbo Lai, et al. (2020). “Factors Associated with Mental Health Outcomes Among Healthcare Workers Exposed to Coronavirus Disease” (23 Mach, 2020). JAMA network open, 3(3), e203976-e203976.

⁹ Muhammad Salman et al., “The Psychological Effects of COVID-19 on Frontline Healthcare Workers and How They Are Coping: a Web-Based, Cross-Sectional Study from Pakistan,” June 2020, https://doi.org/10.1101/2020.06.03.20119867.

¹⁰ Helen J. McLaren, Karen R. Wong, Kieu N. Nguyen, & Komalee N.D. Mahamadachchi. “Covid-19 and Women's Triple Burden: Vignettes from Sri Lanka, Malaysia, Vietnam and Australia”. Social Sciences 2020 9, no.87 (20 May, 2020), https://doi:10.3390/socsci9050087

¹¹ Ibid.

¹² Ibid.

¹³ Ibid.

¹⁴ Inez Miyamoto. Report. Daniel K. Inouye Asia-Pacific Center for Security Studies, 2020. Accessed September 4, 2020. https://doi:10.2307/resrep24863.

¹⁵ Niall Galbraith et al., “The Mental Health of Doctors during the COVID-19 Pandemic,” BJPsych Bulletin , April 24, 2020, https://doi.org/10.1192/bjb.2020.44.

¹⁶ Jianbo Lai, et al. (2020). “Factors Associated with Mental Health Outcomes Among Healthcare Workers Exposed to Coronavirus Disease” (23 Mach, 2020). JAMA network open, 3(3), e203976-e203976.

¹⁷ “Virus Takes Toll on Mental Health of Europe's Medics,” Pakistan Today, May 27, 2020, https://www.pakistantoday.com.pk/2020/05/27/virus-takes-toll-on-mental-health-of-europes-medics/.

¹⁸Zohra Saleem and Mansoor Majeed, “COVID-19 Pandemic Fear and Anxiety among Healthcare Professionals in Pakistan,” June 2020, https://doi.org/10.21203/rs.3.rs-37608/v1.

¹⁹ Inez Miyamoto. Report. Daniel K. Inouye Asia-Pacific Center for Security Studies, 2020. Accessed September 4, 2020. doi:10.2307/resrep24863.

²⁰ United Nations, Sustainable Development Goals, Goal 3: Ensure healthy lives and promote well-being for all at all ages, https://www.un.org/sustainabledevelopment/health/

²¹Niall Galbraith et al., “The Mental Health of Doctors during the COVID-19 Pandemic,” BJPsych Bulletin , April 24, 2020, https://doi.org/10.1192/bjb.2020.44.

²² Ibid.

²³Zohra Saleem and Mansoor Majeed, “COVID-19 Pandemic Fear and Anxiety among Healthcare Professionals in Pakistan,” June 2020, https://doi.org/10.21203/rs.3.rs-37608/v1.

²³Nicholas WS Chew, Grace KH Lee, Benjamin YQ Tan, Mingxue Jing, Yihui Goh, Nicholas JH Ngiam, Leonard LL Yeo et al. "A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak." Brain, behavior, and immunity (2020).

²⁴ Ibid.

²⁵ Ibid

^24“DASS FAQ (Frequently Asked Questions),” DASS FAQ, accessed September 9, 2020, http://www2.psy.unsw.edu.au/dass/DASSFAQ.htm.

²⁵Ibid

²⁶Ibid

²⁷Tian Po Oei, Sukanlaya Sawang, and Yong Wah Goh, “Using the Depression Anxiety Stress Scale 21 (DASS-21) across Cultures,” International Journal of Psychology 48, no. 6 (February 2013), https://doi.org/10.1080/00207594.2012.755535.

²⁷Li-chen Jiang, “The Depression Anxiety Stress Scale-21 in Chinese Hospital Workers: Reliability, Latent Structure, and Measurement Invariance Across Genders,” Front Psychol 11, no. 247 (March 6, 2020), https://doi.org/ 10.3389/fpsyg.2020.00247.

²⁸Sandesh R, Shahid W, Dev K, et al. (July 02, 2020) Impact of COVID-19 on the Mental Health of Healthcare Professionals in Pakistan. Cureus 12(7): e8974. doi:10.7759/cureus.8974

²⁹ Government of Pakistan, COVID-19 Official Portal, http://covid.gov.pk/stats/pakistan.

³⁰ Respondent data was downloaded on Excel and imported into STATA-14 for statistical analysis

³¹McLaren, Helen J., Karen R. Wong, Kieu N. Nguyen, & Komalee N.D. Mahamadachchi. “Covid-19 and Women's Triple Burden: Vignettes from Sri Lanka, Malaysia, Vietnam and Australia”. Social Sciences 2020 9, no.87 (20 May, 2020), https://doi:10.3390/socsci9050087

Saida Waheed Gender Initiative presents a set of seven student projects about the experiences of women, queer folks, and trans persons amidst the COVID-19 pandemic.