HEAL TH SEEKING BEHAVIOR OF ADOLESCENT GIRLS DURING PUBERTY: A CASE STUDY OF VILLAGE TARRAYIA, DISTRICT RAWALPINDI

Abstract

This thes is intends to look into the cultural construct around puberty and its related practices that community adopted, for educating the adolescent girls of village Tarrayia. This complex issue is also surrounded by cuiturai norms and taboos that have made it most sensitive to be discussed openl y and digging out useful and reli able information was a chall enge, but applying the proper research techni ques, made the gathered information tangibl e. It is a complex and pol ari zed issue across many cultures. In most western cultures around the world it is taken as a normal routine happening, and no politics or complexities are surrounding the discuss ion around it. The cultural signifi cance and importance of this practice may be understood by those cu ltures who believe that control of female sexuali ty by limiting access to information is good for their own growth. Yet in other cultures, it is openly di scussed and there is no hindrance in access ing thi s knowl edge, before phys ical and psychological maturity is achieved. The va lues, belief and cultural concepts and practices of these people were only understandable by observing and participati ng in the daily routine activities of the vi llage women and girl s. The research was carri ed in the village Tarriya, of the union council Tarri ya, of district Rawalpindi. This is a very traditional kind of a society, with most decisions taken by men folk. Women have very little role in the decision making process. Men are the controlling forces and women are the impl ementers of their decisions. The transition from chi Idhood to adol escence is governed and guided by stri ct norms, especially for the girl , and as soon as she is about to reach maturity, her mobility becomes major issue of concern for the entire fa mily. There is a strong belief amongst the rural women that information to be shared with ado lescent girl on maturity must be limited and made avail able on her first cycle. This fact is premi sed around the concept that the innocence of the girl carri es significance in this culture. She must not be given that knowl edge whi ch can be mi sleadin g. In the rural set up there is no means for the adolescent popul ation to learn about her body growth and changes associated with it. The fa mily is the only institution which will addresses this iss ue, with mother, elder sister or aunt being the authorized person to deal with prov ision of relevant details. It was found that the adolescent girls reported that they get confused on the information received, and many aspects required clarification s. But no avai lab le means to disc Liss with fri ends or cousins could be adopted as there was no space provided by the community for sharing or discussing it. The educational institutions cannot address this issue because it is cons idered as a norm, and must be covered under the umbrella of the fa mil y. The story is almost simil ar with the case of the marri ed adol escents. They too were fo und to be quite ignorant on issues like spac ing, child birth, contraceptives e.t. c. regarding their first child. Since the decision making powers are vested with the elder fema le (mother-in-l aw), they des pite the willingness to take a certain decision cannot proceeds with it. In the traditi onal fo rm of a society, the appearance of first menstrual cyc le, brings the girl from child to the adul t status, where there is a great concern regarding sexuali ty. This is also a kind of rite of passage for her, and from now on there will be strict eye on her mobility, whi ch is also controll ed. In a few decades back, this was regarded as a sign of her maturity and in many cases the elderly women repol1ed that their marriage was arranged accordingly. If we look into this practice fro m health point of view, many of those practices were lacking aspects personal hygiene considerations. The ado lescent gir ls were facing problems related to their cycles, as back and abdomi nal pa in, infection s, e.t.c but taking a un married girl to a doctor with was an issue, in its se lf. Trad itional methods of hea ling were effective but not always. In case of marri ed adol escent women, going to a doctor was an option for them to dec ide; otherwise the TBA was regarded as effective so urce too, but a few cases of mi shandled child births have lost faith in them. Women and girls were not well versed with their own rights, and this was all related to social ization of young girl s, where it was taught to bow before the decisions of their elde rs. There are many theories that have been proposed by psychologi sts, soc iologists, biologists and anthropologists rega rding the adolescents. The most important work in this regard is of Freud, Stan ley Hall, Erick Erickson, Mead and many others who have addressed this issue. Today there are no boundaries between different fields, and this intra discip linary approach has allowed reviewing this issue from various aspects. Adolescents are world wide a concern because of two reasons, one they are in greater number and second their health is a major concern as they will be the future of a nation. Hence all meas ures are taken to address this aspect. Paki stan with impacts of world economic recession and natural calamiti es, is working hard to deal with this scenario. There have been national level stud ies that have pointed that the adolescents require that their health needs are addressed, they need guidance, support and reliable information. The efforts of the public and private sector need to be enhanced and concerted .In the rural areas where there are traditional val ues and practices, and where the health services are limited, the input have to be doubled both in terms offaci lities and services. The policy of the government is already refl ecting this iss ue, in the form of its national (Millennium Development Goals) and international commitments. (Convention on the Eliminat ion of all Forms of Discrimination against Women, Beijing decelerat ion) The study co ncludes that the adolescent in Pakistan have shown a desire for access on information regarding their growth and puberty.