Ultrasound technician, Dr Zaheer, wearily shakes his head as
a young couple leave his office in the eastern Pakistani city of Lahore. He had
declined to tell them the gender of the child they are expecting.

"It is unethical. I do not tell people the sex of their child, unless I am certain
it is a boy," he said. "But they will probably go somewhere else. There are quite
literally hundreds of ultrasound facilities in this city and despite the code of
conduct on this, it is not hard to find a technician who will tell them the gender,"
Zaheer added.

TERMINATION OFTEN FOLLOWS

Should the foetus turn out to be female, there is a real likelihood that the parents
may choose to abort it. Terminations based on gender have become increasingly common
since ultrasound technology, able to detect the gender of a baby at around four
months gestation, became commonly available.

Amina, aged 25, from a village near the industrial city of Faisalabad, 100km west of
Lahore, is childless. She has been married for five years. In this time, she has
been pregnant three times but each time, she says, her in-laws forced her to have an
abortion because she was carrying a female child.

"I desperately want a baby, but I am terrified of once more having a girl in my
belly," Amina told IRIN. She lives in a society where there is a strong stigma
against childlessness as well as girl babies but she adds: "This time I will fight
really hard to keep the baby."

While the 'missing girls' phenomena has been fairly extensively documented in India,
where a strong preference for a male child has also led to millions of abortions of
'unwanted' females, less data is available on the situation in Pakistan.

IMPACT ON DEMOGRAPHY

Nevertheless, estimates suggest that by 2020, there will be an excess of four
million men. This suggests that, when roughly even numbers of each sex may expect to
be born, an almost equal number of girls have not survived.

Pakistan is one of the few countries in the world where population gender statistics
are skewed in favour of men, demographers say. Out of a population of 149 million
people, there are already 105 men for every 100 women, according to the latest
demographic profiles.

FAVOURING BOYS

The reasons for this go beyond the issue of pre-natal gender selection. As many
doctors will testify, many more girls than boys die under the age of five, since
they are often fed less well than their male counterparts and are less likely to
receive prompt medical care when ill.

"It is generally true, parents bring in sick boys far more often than sick girls. A
girl's health and physical well-being is placed at a far lower value compared to
that of a boy child," said Dr Ahad Abbas speaking to IRIN. He has been posted for
two years to a tiny Rural Health Centre (RHC) near Taxila, in the northern Punjab.

Parents do not deny this bias. "For each of my four daughters, I will need to pay
out a huge sum when they wed, as dowry and as expenses. My two sons will however add
to the household earning," maintained Rafiuddin, a father of six children who lives
in the rural area of Narang Mandi, some 100 km from Lahore. He added, "I love my
daughters, but they are some harsh economic realities that poor people like us must
face."

UNETHICAL BUT COMMON

Nearly a decade ago, as gender determination through pre-natal ultrasound screening
became increasingly common, both the Pakistan Medical Association (PMA), the body of
medical professionals, and the Pakistan Medical and Dental Council (PMDC), the main
regulatory body for the profession, declared it to be 'unethical' to tell parents
the gender of an unborn child.

However, the adherence to the declaration is almost impossible to enforce, with
ultrasound clinics offering gender determination services now operating in almost
every urban locality in a city like Lahore. Too often, the announcement that the
baby is a girl will be followed by a visit to a back-street abortionist, functioning
illegally in the Temple Road area of the city.

"Women come weeping to us, because they are carrying a second or third or fourth
daughter. They are often too scared even to tell their husbands they are pregnant
with another girl. They just want the foetus aborted, so they can try again for a
boy," says Lubna Baji, who runs a busy Lahore ultrasound clinic.

Police are often bribed not to intervene in the illegal trade according to human
rights and gender activists. They say some of the clinics have now even gone so far
as to set up 'one stop' gender detection and if required, abortion facilities.

HEALTH RISKS

"Such abortions are disastrous for women. Many suffer infections that damage their
reproductive organs and in fact leave them unable to bear future children, male or
female," Dr Tabbasum, a gynaecolgist, told IRIN.

Campaigns by the Pakistan government to persuade people that daughters are to be
valued as highly as sons have had only limited impact. So too have efforts by
organisations such as the United Nations Children's Fund (UNICEF).

"Obviously there is lots of discrimination against girl children. We need more
studies to determine in exactly what way this takes place," said Sylvia Pastie, at
UNICEF's Islamabad office.

In families higher up the social scale, where economic pressures alone are not a
major consideration, the desire for sons is still huge.

"No family is complete until there is at least one son," insists Nuzhat Saleem, who
gave birth to four daughters and finally a son.

LINKS TO GENDER EMPOWERMENT

"It's all a question of the status of women in society. No policy, whether it aims
at preventing pre-natal gender detection, or aspires to persuade families that
daughters are as good as sons, can work unless it is part of a holistic plan," said
Nawera Ahmed, a researcher at the Human Rights Commission of Pakistan (HRCP). She
holds that policies must aim at empowering women, educationally, economically and
socially.[Source: IRIN]