“From next month you have to pay Rs34 per litre instead of Rs32,” the delivery man said after pouring the day’s milk early morning.

I was annoyed, not because he was asking me to pay more, I knew many shops were selling it at higher prices, but because the government had failed to maintain price control, and all its claims were mere words.

The war of words between milk sellers and the City District Government of Karachi over its price it seems was lost by the CDGK. The CDGK say it should be Rs28 per litre, the producers insisting on more than Rs34. The milkmen are charging between Rs32 and Rs36, depending on the locality. I was reminded of the meat sellers tactics who increased prices on their terms, and the CDGK could do nothing. It seems the government has no writ and monopolies and cartels hold sway while the consumers lack the will to stand up to such exploiters.

So when my milkman sounded the warning, I saw no wisdom in arguing. However, I was reminded of a news report which said that a Sindh High Court bench had fixed Rs32 per litre as the interim retail price of milk till a price was agreed upon by all stakeholders. The matter will come before the court on May 8. Under this order the wholesalers will supply milk to retailers at Rs30 per litre till a price is finally agreed. My concern is how much more will I have to pay, and why are the milk sellers not abiding by the court’s interim price order.

I was, however, amazed to hear his allegations against the CDGK officials that a hefty amount had been doled out to grease palms. Such allegations are not unusual. But when you are at the helm of affairs and do not come up to people’s expectations such allegations gain ground.

Ironically the CDGK, had insisted that a litre of milk be sold at Rs28, and even considered this to be on the higher side. It issued a notification on April 9, fixing the price at Rs30 per litre, on the court’s directive.

The milk sellers claimed the CDGK had no authority to fix commodity prices as price fixation was the provincial government’s domain. According to a committee appointed by the provincial animal husbandry department, the production cost of fresh milk amounted to Rs33 per litre and it could not be sold for Rs28 or Rs30 without incurring loss.

But the question is do we really get ‘fresh milk’? Many people say the water content in milk has crossed 50 per cent. The other tricks used by the milk sellers are adding other materials to increase the product’s thickness and to make it appear fresh.

Given the quality of water in the city and the unhygienic environment in which the cattle pens operate, I suggested to my wife to switch to dry milk. At least we will mix water of our own choice and also maintain a reasonable ratio. She agreed but said pointedly: “But each time I visit the grocery store there is a new price tag on powdered milk. What is the guarantee they will not take advantage of the surge in demand?” However, we have decided to switch. Let’s show some consumer resistance?

Karachi: For Chanda, talking her troubles away at sufi shrines such as Sehwan Sharif or Abdullah Shah Ghazi gives her a new lease on life. “Who else has the time to share my burdens? I go there every three to four months and they keep me sane,” says the fifty- year-old maid. Married to an older drug addict since the age of sixteen, she has raised six children on her own income.

Most women in Chanda’s decrepit neighbourhood of Azam Basti turn to various shrines for both hope and catharsis. They say that doctors and herbalists have failed to treat their inexplicable states of lethargy accompanied by body aches, fever and a general sense of despair.

“We are used to these aches and pains now. I cannot spend more money on my issues. Going to maula (Abdullah Shah Ghazi) is an outing and I feel lighter,” says a matter-of-fact Nargis, a young widow who works in five homes as a sweeper to support her four children.

Cut to the alter reality in Karachi’s upscale quarters, where luxury does little to assuage desolation. Shaheen is an affluent housewife with two children in Ivy League colleges and a wide, active social circle. “My siblings and friends envy my comfortable lifestyle. But ironically, I find it hard to get through the month without a visit to my therapist,” she confesses tearfully. “A feeling of hopelessness hounds me constantly and I feel so misunderstood by those close to me.”

Shaheen has been advised by her associates and doctors to look for distractions such as taking up an occupation which will create a sense of contentment within her. “I haven’t worked for a day in my life so I have no confidence and, besides, my husband will see it as an affront to his status.”

Shaheen is not alone in her anguish. Shazia is a single woman and a successful banker from a well-heeled business family who feels that familial and societal pressures have made her cave in psychologically. She has been prescribed anti-depressants and, oddly enough, this has intensified her strains rather than alleviate them. “I am under tremendous pressure to settle down and then there is work stress. I feel like I am at a dead-end in my life. My problem is compounded by the fact that there is depression on my paternal side so it can be genetic too,” says the thirty-year-old. “I am taking medication but it has added to my problems. There is a constant fear of dependence and loss of control.”

Renowned psychiatrist Dr Unaiza Niaz has conducted a study on the rise in depressive disorders amongst upper- and upper-middle-class women which illustrates that the most common cause is marital conflict: almost 30 per cent of female patients of depression are prey to it. A close second is disharmony with in-laws at 12 per cent and the lack of meaningful employment is a surprise at 14 per cent.

“Marriage can have detrimental effects on women. It poses gender-specific demands, resulting in limited roles for them in paid employment or puts additional responsibilities on those who are employed,” explains Niaz.

According to the survey, 77 per cent of the women are literate enough to generate their own income but 61 per cent are housewives. Also, 3.6 per cent of educated upper- and upper-middle-class women face domestic violence and another 0.5 per cent have suffered a separation or divorce.

Dr Unaiza believes that tradition and culture have a direct and major impact on the identity of women living in multi-ethnic societies. “Urban women in Pakistan are under immense pressure as they have to meet cultural, religious and modern socio-economic demands of time.” Niaz asserts that turbulent relationships with in-laws and husbands remain major contributing factors in the increased prevalence of depression.

Patrice Khan, a specialist in stress management and a recognised counsellor, seconds Niaz’s view. “The area of marriage remains the most complex. For some, finding a partner causes much angst and then the joint family issues are rampant. I have more working women coming to me because the combined stress of home and office intensifies their situation.”

According to Khan, family members here have a lot more influence over each other than they do abroad. “Most of the people who come to me have been educated abroad and are re-entering life here. They find that everything is dictated and they are not allowed to think for themselves.”

Depression remains the most common complaint amongst Khan’s patients who are primarily from the upper-middle-class. “But I don’t label their depression. I use a more solution-oriented therapy through technology and emotional exercises. It is more about shifting their belief systems.” Khan’s approach includes breathing techniques, emotional exercises to calm the autonomic nervous system and sustain coherent chemical levels in the body including hormones.

For the likes of Chanda, however, self-help is all there is. Be it the corner shop of the neighbourhood hakim or the shrine, her salvation lies in the power of her own mind. “Lower-class women just exist. They age faster, have multiple births and are mild to severely depressed. Their resilience is seen only in their endless struggles. They have no life of their own but live for their family,” says Niaz.

Another leading psychiatrist Dr Haroon Ahmed, attributes Chanda’s resilience to the fact that she is so involved that there is little or no time for her own self. “In the lower classes, women are juggling multiple responsibilities at home along with their employment,” says Ahmed. He also believes that the lower-middle-class male is quicker to seek therapy than a woman. “Although women are twice as vulnerable given their biology, it is the male that comes forward because he has more earning power and the woman is not valued as much.”

Commenting on the more visible role of the psychiatrist today, both Niaz and Ahmed agree that greater awareness of psychiatric illnesses has come about because general practitioners are more sensitised to depression amongst women.

“Bodily symptoms such as headaches, backaches, fainting spells, obesity or anorexia are somatisation of depression,” says Ahmed. Depression, Haroon stresses, is not a mental but a biochemical disorder not to be mistaken with more visible mental illnesses such as schizophrenia.

Dr Unaiza also includes natural and man-made disasters as factors which have contributed towards diluting the stigma attached to seeing a therapist. “Psychiatric help has become more in vogue since the Gulf war, 9/11, tsunami and the earthquake.”

Unfortunately, the rise and rise of the psychiatrist has so far failed to highlight the importance of family therapy, primarily because most men view it as an admission of defeat. In a scenario where fractured relationships constitute a major part of the causes, individual-driven treatments can only provide short-lived solutions. Perhaps the answer lies in facilitating support-focused healing whereby recovery is more self-reliant and complete.

Students of a joint government school for boys and girls at Kahliyaan, Bajwat, get education under the shadow of trees. This school has no building. A rainy day becomes a holiday for students. Once there were hundreds of students in this school. But now the number has come down drastically due to lack of basic facilities.

As many as 80 state-run primary schools in the district have no buildings and their students are forced to get education under the open, officials of education department admit. Ten primary and high schools have been converted into cattle pens as officials concerned are indifferent to the situation.

The buildings department had recently declared the old structures of 145 primary and middle schools as dangerous and asked the education department to evacuate their students to avert any tragedy.

According to officials of the education department, there are more than 52 boys and girls primary schools in the district where there are no teachers.

There are 2,825 government schools in the district, including five boys’ higher secondary schools, 13 girls higher secondary schools, 83 boys high schools, 80 girls high schools, 83 boys elementary schools, 80 girls elementary schools, 734 boys primary schools and 170 girls primary schools. Besides there are 510 Masjid-Maktab schools.

A vast majority of these schools have been suffering from different deficiencies — lack of staff, furniture, no maintenance etc.

Government Girls High School, Looni, Bajwat has been lying closed for the last nine years. Local villagers have converted it into a cattle shed.