Shazia Bibi: the many costs of illness

IFAD Asset Request Portlet

Agrégateur de contenus

Shazia Bibi: the many costs of illness

Shazia Bibi, in her mid-thirties and a mother of three, lives in Khyber Pakhtunkhwa, Pakistan, where she and her husband are small farmers. Much of her testimony focuses on the material and emotional impact of serious illness in the family.

Throughout her childhood Shazia's father suffered from a blocked heart valve. His erratic wages from day labouring in Karachi all went on medical treatment. "If for one day he was fine, he spent two days working, on the third day he became unwell and ended up in hospital... He actually didn't come home [much] because he didn't have anything to give to his children", Shazia says.

Shazia's mother struggled to support her five children through sewing and selling milk from their livestock. All the children left school after primary level because of lack of money, and Shazia and her sisters helped support the family through sewing and embroidery.

Soon after marrying at the age of 18, Shazia herself became ill, also with a heart condition. Tests, medication and travel to several different hospitals were a huge financial strain, costing tens of thousands of rupees: "I went on for all of three years in [and out of] hospital, here and there … And after three years I had an operation." At first, while her husband was in the army, some treatment was covered by the government. When he retired she went to private hospitals.

Her husband had further responsibilities. "We have a joint family system," Shazia explains, "Our entire family was [my husband's] responsibility… My brother in law [also] fell ill and then there was so much illness. Illness didn't give us a break so that we might be able to save something."

Ten years after her operation, Shazia has to go to a private hospital every three months for a check-up and will remain on medication for the rest of her life. The loan taken out for her operation has yet to be paid off.

Shazia and her husband grow vegetables, garlic, taro, maize and wheat, and market part of their crop, though the profits are scarcely enough to pay for the children's education and Shazia's continuing treatment.

Once the crops are ready to harvest, Shazia's family checks current market prices against the costs of land rental, seeds, fertilizer, pesticides and some hired labour. "If all our costs are covered," Shazia says, "then we immediately take [the crop] out of the land and take it to the market in Abbottabad." If they predict selling at a loss they store the harvest at home, a time-consuming process as the crops must be cleaned and shifted from room to room every 15 days to avoid termite infestation.

The family also keeps a buffalo, some goats and a hen, mostly using their products themselves, but selling most of the buffalo's milk: "With this we try to improve our condition to some extent,"Shazia says. The buffalo manure also reduces their spending on artificial fertilizer.

Evident at various points in the interview is the high value Shazia places on education – not only for improved employment prospects but also for broader personal development: "…education makes a good human being", she says. Disappointed that her own education was cut short, she insists: "…if we can save even a straw we will definitely educate our children." But she is concerned about understaffed government schools: "…in our village the children that study now… [are] around 600 … There is one government school. It has two teachers, then how will they educate the children, these teachers?"