“When the silence and the aloneness press down and around me, crushing me, carving through me like ice, I need to speak aloud sometimes, if only for proof of life.”

I have learnt two things in life about myself.

Firstly, I can recognise the people who love me. For they gift me books. Those who love me a little more than I deserve, give me good books…and so, ladies and gentlemen, I can now say with sheer confidence, that Gurmi loves me!

Secondly, no matter how hard I try at keeping psychiatry away from my immediate world, it has always persevered and presented itself when I am least expecting it. This time around, it was in the book, which Gurmi gave to me on my final day in Oxford, Eleanor Oliphant is completely fine.

The protagonist of the novel is a thirty-year old female whose existence is one of a fixed routine. Eleanor Oliphant works in an accounts department and her daily routine consists of work, vodka and isolation. We come to learn of the low opinion her coworkers have of her, and she of them. We appreciate the pathological communication (well, mainly lack of) she has in her world. We also become aware of the extent of her socially awkward and uninformed framework of her limited world. Many of the book launch and discussion events, in addition to the book’s original description, pointed towards the theme of loneliness being integral to the premise of the story.

Many moons ago I once narrated to someone my ideas of mankind’s predestination to remain eternally alone. Be it in stable relationships or in the company of friends…we always come back to small corners lurking on the edge of our existence. These corners are sacred for they are closed to the rest of the world, no matter who they are. The only thing that has the power to reside in these are our own thoughts and reflections. Or so I thought in my speech, which at the time, was full of fervour, philosophy and youth.

So, recalling this conversation whilst reading the book, I was hoping to get more of a literary insight into the concept of loneliness and was eager to see how it manifested in a modern day character. However, for much of the novel, Eleanor was not aware of her loneliness and when she did become aware of it, there was a lack of tangible processing and coming to terms with an event, which I would classify as fairly significant. I would have imagined that the realisation of your solitude would bring about a weight heavy enough to crush your soul and sad enough to break your heart. The anxiety and distress associated with these sudden realisations was lacking, and as such, so was my empathy for the character.

To say I had mixed feelings about the novel would be an understatement. It was hard to understand or appreciate this character, who initially did not seem lonely; rather, just socially awkward, unforgiving and narrow minded. As the novel progressed, it became apparent as to why Eleanor was who she was (and trust me, she was not completely fine). Gradually, we learn more about the character, her past and the implications of it.

The novel touches upon aspects of Eleanor’s behaviour and rationalises it through the lens of severe trauma, which she learns of through a cliched approach of a counsellor.

The issue with the perception of mental illness through the lens of pop culture is precisely this – the notion of talking things through with a therapist and approaching the so called nirvana of enlightenment. To her credit, the author makes the process somewhat painful and somewhat difficult for the protagonist, which is the tiniest indicator of how difficult it is to live with and work through mental health issues. Nevertheless, the glorified therapist and couch culture, is not the entire (arguably, not the truest) depiction of psychiatric medical care.

I suppose the book offered hope in that snapshot of Eleanor’s life, where things are ok. However, realistic nihilism has been at the centre of my existence for a while. So I shall leave it there…hoping not to break facets of hope amongst the existentialists.

So, is it a good book? In its principle, yes, for any book creating awareness of the complexities of a human condition cannot be bad. Would I recommend the book as a good read? No. However, I am glad to have read it to come to this opinion.

“What saddened Ronojoy was that his mother had underestimated the innate human capacity to forgive a loved one. Wasn’t this, essentially what made us humane – to see how fallible we all were, and to make allowances for it, for each other?”

Mukherji’s debut novel throws its readership into the varying depths of darkness associated with the trials and tribulations of two brothers, Ronojoy and Sujoy, who navigate their lives after the death of their estranged mother, Mala. Please note, the novel plot will be discussed at some length and there will be a significant focus on honour-based violence, which is not associated with the novel, but remained a thread of extra thought whilst examining the themes presented by Mukherji’s characters.

Subsequent to Mala’s cremation, Ronojoy is given a letter, which his mother wrote for him prior to her death. The letter is a confession regarding her acts of infidelity, a son out of wedlock, continuing self-blame for the consequences of all involved, and the guilt of not being an adequate mother. Ronojoy is left not only with the trauma relating to the letter content, however, also toils in the dilemma of sharing this with his brother, which he eventually, reluctantly, does.

Ronojoy and Sujoy have different feelings towards their mother, the latter being angrier and the former having resentment but warmer sentiments. During their childhood, and shortly after the suicide of their father, Subir, Mala sold the family home and retreated into an ashram, after sending the boys, aged twelve and six, to a boarding school in Nainital. From this point onwards, the primary maternal figure in their life was their maternal grandmother.

The novel, in its premise, is a simple one. However, interlaced with each character and their respective stories are questions that we ask of their lives, of our lives, of the choices our families make…and ultimately, questions to the society itself, which has firmly placed moral and social constructs through which we, often helplessly, weave our narratives.

The moral and ethical dilemmas were centred around the apparent shortcomings of Mala – it was her infidelity, which was unforgivable for her husband and was a causative factor for his spiral into depression, and eventually, suicide. She distances herself from her children due to feelings of inadequacy as a wife and mother and the relentless blame for the consequences her actions had on her family’s life. The added difficulty, for the family and to a degree, the readership, was to reconcile with the man she had a relationship with, Apu, who was the Subir’s brother. Apu had left for the USA soon after the death of his brother and chose to settle there.

Whether the author intended for this or whether it remains a subconscious bias, the social norms of blaming the woman were woven throughout the novel. Her marriage had broken down three years prior to her relationship with Apu and she was merely cohabiting with Subir. We are not informed of why the marriage broke down. It is important to consider that if one is to blame this woman for her choices then scrutiny of her marriage becomes crucial. Was this a marriage of two people who did not love each other? Were things repairable and was effort placed into this? Was Subir’s depression a key factor in the breakdown of everyone’s life? Why did they continue in this marriage when both were uninterested?

What will continue to surprise about the human condition is the lack of confidence in open and honest discussions humans can have whilst discussing the intimate details of personal lives. One can fixate on the guilt for not loving partners or being bored in relationships, however, there seldom is a discussion on such topics for the fear of judgement or the effects it may have on children. Perhaps, on a basic human level, there is a deep-seated fear of the unknown consequences of a decision to move away from unhappy relationships – and such is the power of this fear that we often choose to remain solidly in our misery.

In the context of the novel – Subir and Mala cohabited despite the lack of love or any significant relationship. One can argue that such arrangements are to afford psychological security to children and not displace them from both their parents. Why do we not question the effects of such fractured relationships upon the children and how it can set unhelpful and almost, pathological expectations of relationships. In many regards, such arrangements can set in stone the choices our children make in their personal lives for it is all they have known and experienced. We shield them from one major traumatic event of parental separation, however, we do not consider the hundreds of smaller traumatic events in their lives, which they bear witness to through the cracks in their parent’s relationships. We solidify the same beliefs – to continue to remain in unhappy relationships and not to leave comfort zones. We cut their wings and deny them the confidence that they WILL be alright in the abyss known as life – because as parents, we will have fulfilled our duties in building their resilience and equipping them with emotional life skills.

Certainly from an Eastern perspective, the difficulties women face in ending relationships are astronomical. Not that it remains completely easy for men, however, there is a relative acceptance afforded to them by the societal norms purely due to their chromosomal order. The onus is on women to remain loyal and with their husbands until death does one part. If a man is disloyal, then certain sub-groups accommodate that with a classic cliche, “He is a man…why are you worried? You remain the wife…she is just a distraction”. Such phraseology is common – not only the emotional needs of such “primary women” are discounted here but the “other woman” is brandished dispensable and a fallen commodity. It is THIS fallen woman who is then blamed for breaking a marriage, not the man who also consensually engaged.

In the novel, Sujoy is abrupt with his family and relations are damaged to the point where his wife leaves home. His brother asks her to be patient as it is a difficult time for him. How often have we given space and asked our fathers, brothers and sons to be patient when the woman is going through distress? I often wonder why such courtesy is seldomly extended towards women – at least in the contexts that I am familiar with.

And the concept of choice remains inherent when considering any relationship – extra marital, pre marital, etc – the choice to remain in a relationship, the choice to leave a relationship, the choice to do with one’s body as they please and with whom they please. At a molecular level – is it the business of any other entity with whom you have consensual relationships with? Mala did not appear to have anything of substance in her relationship with Subir – why the judgement from every individual allied to her when she sought to fulfil her needs? Did Subir have the right to object when he had long left that aspect of the relationship, or indeed, the sanctity of marriage itself?

The transgressions a man makes are catered for with great ease in various societies. However, when it is a woman, then the central issue is not one of infidelity as a human, rather, the dishonour she has brings upon the family. The concept of women being equated to honour is yet another example of the insidious control patriarchy has fueled in the concept of ownership. At its worst, this control and ownership have often manifested through honour-based violence. Although in no way affiliated with the content or context of this specific novel, some time will be taken to lament on this thread of thought.

Honour based violence can centre on various acts or choices, which include individuals voicing their choice to not engage in arranged, force or child marriage; divorcing or separating out of choice; engaging in premarital or extramarital sex; dressing “inappropriately” to the norms of specific cultures, and even being victims of rape or sexual assault.

Punishments can vary from divorce or retaining the woman as a man or family pleases; in various jirgas the elders have ordered the woman to be gang-raped as honour revenge e.g. the case of Mukhtar Mai in Pakistan; and ultimately, it can be decided that a transgression is worthy of an honour-based killing. The United Nations has estimated approximately 5000 honour-based killings per year, however, various NGOs have cited concerns of the underreported data and predict that the true number is closer to 20,000 honour-based killings a year.

There is a myth that honour-based violence is very unique to the eastern world and primarily to those in India and Pakistan. Both countries certainly have a high rate of honour-based violence, however, this problem exists beyond the realms of the Subcontinent and certainly extends to Europe, where the numbers of such crimes are rising.

There remains a need for continuous revision and execution of laws pertaining to honour-based violence, however, more importantly, there is an urgent and dire requirement of present-day social education reforms. Looking at this in a historical context, Roman laws made it lawful for fathers and husbands to murder their daughters and men they had been intimate with out of wedlock. Such laws and sanctions were echoed in the French Article 324, which was repealed, however, not before it inspired many Arab laws of honour and related punishment.

Examining the specific context of the Pakistani legal system; honour-based violence became punishable by a prison sentence only in December 2004. However, the public sphere remained emboldened to continue to engage in honour-based killings and the problem here lies in their sense of accountability, which is a direct result of poor law enforcement and laxity from the legal system based on personal religious and cultural biases. An example is of the Women’s Protection Bill, which was initially rejected in 2005, due to reluctance of branding honour killing as un-Islamic. Furthermore, it was only in 2016 that the legal loophole was closed, whereby families could seek forgiveness for the violence and escape legal repercussions – and only in June 2016, the Council of Islamic Ideology, which advises the Government with regards to compliance of laws with the Islamic Shariah, was able to decree that honour killing is un-Islamic.

Despite assurances of protective bills, why is the rule of law not prevailing in a country as Pakistan? The perpetrators have unilateral and unwavering views regarding honour, which are often falsely based on their ideas of Islam and its message – and these individuals have no incentive to educate themselves in the name of the religion they feel comfortable to kill in. Secondly, the ambassadors of law also remain uneducated on a similar level and will carry out their civil duty through the lens of their prejudices and personal views on honour and shame – most of whom are men identifying with a skewed view of Islam.

So what is required? The state must remain secular and deliver its duty in the spirit of law equal to men and women and provide relevant protection to the vulnerable and enforce the law against perpetrators.

Finally, we must consider our views about women, especially those confined to marginalised societies and/or situations. Not in the context of their gender, but in the context of their human rights. In order to do justice we must look at women from the confines of their personal spaces to their roles on a global platform – and ask the question – are we doing justice to them in the name of law, religion, culture, equality – but more importantly, humanity?


Meri zaat se toot kar wo shakhs begaana hua
Uss zamanay ko bhulaaye huay bhi zamana hua

Hai mustaqbil ghafil mujhse aur maazi naraaz
Iss khalla mein bhikarnay ka jaisay bahana hua

Ranga uske rang mein aur khilla uske dhang mein
Kay fareb karne par bhi na dhukh na ghabrana hua

Mujh mein aib taraashne ka aik hunar tha uss mein
Bohot mushqil se mera daaman ko bachaana hua

Kitni raghbat thi uske naam se pehle pehle
Ab to jaise uska zikr bhi mujhe sataana hua

Udaas parinde bhi dene lagay hain sadaa
“Laut jao, bohot intezar main jagna jagaana hua!”

Gar nadamat mein khud hi sulagte rehte hain
To youn be‘maqsad kyun meri raakh ko jalana hua

Mere naseeb ke baadal barse hain kahin aur,
Youn uska mere harf-e-dua mein thikaana hua

Doorion se usse vehshat aur qurbaton se darr
Batao kya chahte ho ke bohot ye aazmana hua

Kab tak zabt ki giraft mein ulajhta rahoon mein
Ae sitamgar bas kar, bohot tera rulaana hua

Dene hain yahaan bhi agar vaastay khuda kay
To phir ae saaqi kiss kaam ka tera maikhana hua

Kyun uljhaa rahay ho meri saanson ko tum youn?
Jaanay bhi do na ke ab, bohot jaan se jaana hua

Mat poocho mera haal, karo na hamdardian
Ab bas bhi karo Zaib! Keh dia na,  tamam wo afsana hua!

/Aib/ – Fault
/Begaana/ – Stranger
/Be’maqsad/ – Without reason
/Fareb/ – Deceit
/Ghafil/ – Neglecting
/Hunar/ – Skill/art
/Maazi/ – Past
/Maikhana/ – The Pub, bro!
/Mustaqbil/ – Future
/Nadamat/ – Regret
/Qurbat/ – Closeness
/Raghbat/ – Attraction
/Tamaam/ – Complete
/Taraashna/ – Carving/engraining
/Zabt/ – Restraint / control

Written for and published by The Rights Collective.

The definition of caste

Caste is an identification and social stratification system acquired through birth and often sustained by endogamy. Caste, although closely interlinked, is distinct from class, race and ethnicity. It is a form of association and social capital and a form of social separation and ranking. Caste has historically restricted and penalised individuals through various exclusions in arenas of education, health, employment, politics and personal life1.

Practically, the organising principles of caste are based on a hierarchy with those “at the top” being perceived to be the purest and able to enjoy social privilege and entitlement, whereas those “at the bottom” are perceived to be polluted, untouchable and their very existence is considered a punishment for their sins.

Historically, those “at the bottom” of the rung served society in tasks that were considered lowly and beneath society. Socially, they were prevented from walking on the same roads as those belonging to higher castes, not allowed to drink from the same water source, and not permitted to “contaminate” the eating vessels. They were even prohibited from praying to certain Gods, could not enter certain temples and had different schools, should they be fortunate enough to be able to go to school at all2.

Whilst Article 15 of the Indian Constitution (1950) has outlawed caste discrimination3; there is still very much a practical and ideological practice of caste and caste discrimination that exists in India and anywhere Indians have migrated. Citing the National Crimes Record Bureau, author Arundhati Roy, in The Doctor and the Saint, scraped the surface of the tribulations faced by Dalits or Scheduled castes in India4. She writes,

“A crime is committed against a Dalit by a non-Dalit every sixteen minutes; every day more than four untouchable women are raped by Touchables; every week thirteen Dalits are murdered and six Dalits are kidnapped. In 2012 alone…1,547 Dalit women were raped and 651 Dalits were murdered. That’s just the rape and butchery. Not the stripping and parading naked, the forced shit-eating (literally), the seizing of land, the social boycotts, the restriction to access of drinking water”.

Not only do the discriminatory practices exist in the subcontinent – the mindset has migrated and reinforced across borders – in the places we call home, and as such we have a duty to understand, challenge and rectify something that sits deep within our communities, within our cities and towns and somewhere deep within our psyche. It must be understood so that it can be challenged and amended.

The origins of caste

The origins of the caste system can be traced to the Rigveda, a collection of ancient Sanskrit texts. The creation story describes the division of Purusha, a primordial being, into four varnas, or castes, namely, the Brahmins from the mouth, Kshatriyas from the arms, Vaisyas from the thighs and Shudras from the feet. Each had specific roles from a divine and social perspective. The Brahmins were priests ordained to recite and teach the Vedic scripts; the Kshatriyas were warriors who protected society; the Vaisyas were merchants who engaged in trade, financial and agricultural matters; and the Shudras were the labourers who served society. A fifth category, excluded from the varna system, comprises of “untouchables”, later Dalits.

Dalit is a political term, which means broken in Marathi. This term has also been used interchangeably with Scheduled Caste. It is a political umbrella term, which includes individuals from various castes who have been subjected to the practices of untouchability.

Caste-based discrimination was firmly embedded by the 2nd Century CE with the compilation of the Law Code of Manu, an influential Hindu text citing decrees and regulations and ideas on purity and piety. The laws were caste-based and placed the severest sanctions on Shudras, whilst establishing the Brahmins as conciliators, things worldly and divine. Logistically, the enforcement of the Code varied depending on local practices and it was the British implementation of these laws, which exacerbated already existing caste discrimination, which persists today5.

The British Raj

The administrative, logistical and scientific flaws by the British influenced not only the colonial policies relating to structuring and politicisation of caste and state sanctioned hierarchy; they have also arguably led to sustained discrimination and enduring toxic outcomes for Dalits today.

The East India Company’s First Governor General of India, Warren Hastings, in 1772 directed its courts to pass verdicts based on the Law Code of Manu and to formalise caste law6. Given that the Code was in Sanskrit and not an area of remote expertise for the British, there was a heavy reliance upon the educated Brahmins to interpret, translate and accordingly advise the British. Through this, the state consolidated higher caste privileges and enshrined it within governmental legitimacy and thus tighten the “Brahminical grip” on British India’s subjects. The regressive practices of caste-based discrimination were not lost upon the British and it was recognised that the institution’s enablement of caste was a significant impediment to India’s social progress. This realisation was exploited for British gains.

The East India Company, and subsequently the British Raj, had interests centred on cost cutting, raising revenue and firming their grips on the country they ruled. Thus, there was no incentive to dismantle the caste-based system and the associated impact of caste-based discrimination. Rather, the caste-based divide offered lucrative means of control for the British.

Some stated that although “barbaric”, caste was the fabric of Indian society and thus did not warrant governmental interference unless it specifically affected the state. Some took the view that by dismantling caste in the name of human rights the repercussions would entail revolution and anarchy. The Vellore Mutiny (1801) and Sepoy Mutiny (1857) led the British to spend a significant amount of time, effort and financial input to gain a fuller understanding of the local Indian demographics in order to find allies against future uprisings as well as local aid in stamping out potential revolutions7. Indeed, the caste-based system proved beneficial for the British Raj not only financially, but also, diplomatically. Encouraging discord between different caste groups made a unified Indian front against the Crown an unlikely endeavour and therefore a way of assuring continued British rule.

The Partition

British departure from India came with the Partition of 1947, which saw the formation of a new nation, Pakistan. During the Partition, the eastern province of Bengal was split into a Hindu majority province (West Bengal) and a Muslim majority nation of East Pakistan, which is present-day Bangladesh.

The national and provincial borders came at a cost of one million lives and twelve million displaced peoples, arguably, the bloodiest mass migration in history. The Independence from the British was followed by a personal and state wealth, communal violence, and loss of lives. Quite aptly summarised by the prolific author Khushwant Singh8;

“The fact is, both sides killed. Both shot and stabbed and speared and clubbed. Both tortured. Both raped”.

The communal violence associated with the Partition is often presented as only between Hindus and Muslims. Embroiled on both sides of the partition and bearing the brunt of it to present day were the Namasudras.

The Namasudras, a Scheduled Caste, were largely situated in East Bengal. During independence, Namasudras were involved in discussions and negotiations with political stakeholders under the Dalit movement to secure equality and social justice. Their support was needed politically, and they were promised political representation for a move to the “Hindu West”; what transpired was effectively minimal political involvement, ineffective mobilisation and a geographical displacement coming at a personal cost far greater to them than others9. The post partition economic situation, famine induced starvation and residual communal violence merely changed the location of the difficulties Namasudras would face from the East to West. The very State, which once sought alliances with the Namasudras, eventually employed measures to evict and purge them from the West as they rallied for their rights. They encountered financial sanctions, political imprisonment, police brutality and sexual violence. Many still await political and legal recognition as Indian citizens10.

United Kingdom

Caste-based discrimination is not only a problem in a country thousands of miles away from us. Prejudice and discrimination also affect the 250,000 Dalits for whom UK is home, where there is an overall population of 4.5 million South Asians11. Studies have concluded that notions of “untouchability” and its underlying ideologies not only migrated with the diaspora but they actively persist with discrimination occurring within the educational, health, professional, religious and personal spheres.

The British Government amended the Equality Act 2010 (Section 9) to make caste an aspect of race, thereby making caste discrimination effectively a form of racial discrimination. However, caste discrimination does not have legislative protective measures that explicitly prohibit it. The current framework of handling caste discrimination is via case law provides insufficient protection for the victims as the Courts may have varied interpretation of the Equality Act 2010 with reference to caste.

The half-hearted attempt at giving a legislative power to outlawing cast discrimination has led to the reluctance of victims to take the legal course of action and as such, there remains only one case, Chandhok vs Tirkey (2014)12. Other barriers to seeking legal aid include pressures from social groups, fears of retaliation and of course the financial implications associated with litigation.

For social justice to be upheld with respect to caste discrimination in the U.K., the law must be clear, as must the path towards it, which unfortunately, is simply lacking in the British legal discourse. The importance of a robust legal framework accepted and adhered to within the community are paramount to social equality and justice. Ambedkar said,

“If the fundamental rights are opposed by the community, no Law, no Parliament and no Judiciary can guarantee them in the real sense of the word”.

The U.K. does not have adequate legislative framework at present and thus the real journey of educating and socially normalising the wider community remains a distant dream until the former is realised.

The world is not a disconnected phenomenon. We can no longer remain in our ivory towers and look down on caste discrimination as “a problem of the East”. India is a major economic power and we have business, political and personal affiliations with it. To choose the path of silence is a passive complicity and acceptance of the breaches in Dalit human rights, be it home or across international waters.


  1. Dirks NB. Castes of mind. New Delhi: Permanent Black; 2003.
  2. Rodrigues V. The essential writings of BR Ambedkar. New Delhi: Oxford University Press India; 2004.
  3. The Constitution of India. India; 1950.
  4. Roy A. The Doctor and the Saint: Caste, Race, and Annihilation of Caste, the Debate Between B.R. Ambedkar and M.K. Gandhi. Haymarket Press; 2017.
  5. Heath B. The impact of European Colonialism on the Indian Caste System. E-International Relations; 2012.
  6. Riser-Kositsky S. The political intensification of the caste system: India under the Raj. Penn History Review. 2009; 17 (1): 31 – 49.
  7. Ambedkar BR. Dr Ambedkar on the British Raj. Edited by DC Ahir. New Delhi: Blumoon Books; 1997.
  8. Singh K. Train to Pakistan. New Delhi: Penguin Books India; 2009.
  9. Dwaipayan S. How the Dalits of Bengal Became the ‘Worst Victims’ of Partition. The Wire: History. 2009. (https://thewire.in/history/partition-dalits-bengal) (Accessed August 2020)
  10. Bandyopadhyay S. Partition and the Ruptures in Dalit Identity Politics in Bengal. Asian Studies Review. 2009; 33 (4): 455 – 467.
  11. International Dalit Solidarity Network. Country profile UK. (https://idsn.org/countries/uk/) (Accessed August 2020)
  12. Ford M. Caste discrimination under UK law. Oxford Human Rights Hub: Equality and none discrimination. 2015. (http://ohrh.law.ox.ac.uk/caste-discrimination-under-uk-law-chandhok-v-tirkey/) (Accessed August 2020)

Written for the Workforce Race Equality Network (WREN) blog article for Leeds & York Partnership Foundation Trust.

“A just society is that society in which ascending sense of reverence and descending sense of contempt is dissolved into the creation of a compassionate society”

— B.R. Ambedkar

The South Asian Heritage Month (SAHM) was initiated this year and it runs from 18th July to 17th August with the purposes of commemorating and celebrating South Asian heritage and cultures within the context of their contemporary and historical relationship with the United Kingdom.

The socio-political discourse of two distinct geographical areas on a map, namely, the UK and South Asia have forced individuals, groups and entire nations to consider the issue of identity at various points in history – I certainly am no exception to this query of “Who am I?” and “Where do I belong?”. Unfortunately, just by being born and nurtured in this country has not automatically afforded me the luxury of confidently claiming to be “British”, without being challenged. Compartmentalising and categorising my existence exclusively to a British or Pakistani framework are an impossible and an unfair ask. The truth, and perhaps the essence of my identity, is somewhere in between and thus both must be acknowledged.

The celebration of my heritage does not merely start in Balochistan or Punjab, where my parents were born. Rather, it starts long before the British colonised India, where my ancestry lies. The Indian subcontinent was the epicentre of one of the oldest civilisations in the world, the Indus Valley. The region has rich tradition in the fields of language, literature, music and contributions to the earth, basic, medical and social sciences.  Similarly, my complicated relationship with my British heritage is a direct result of the colonisation of my ancestral home and its aftermath.

The British rule over India lasted over two hundred years and ended with the Partition of India and formation of East (present day Bangladesh) and West Pakistan. The Partition is one of the biggest mass migrations in world history, which left one million dead and over twelve million people displaced. The contributions, albeit non-consensual and enforced, of British India to the Crown have been great. India provided raw materials to Britain that were used to flood the world market and thus providing an astronomical amount of wealth to Britain whilst concurrently destabilising the Indian economy. Economists believe had the region not suffered this economic setback at the time of independence, the region’s economy would not be in the dire state it is today. The native manpower also provided a backbone for the British army and saw the largest contributions from India to both the world war efforts.

Following British withdrawal from its colonies and the aftermath of WW2, the UK had a severe labour shortage and thus encouraged economic migration and promised British citizenship to those from Commonwealth nations.

As my forefathers joined other immigrants to work in various British sectors, they faced racial discrimination and violence. My parents were told on many occasions to “go back to where you came from”, whilst my school contemporaries found it acceptable to scribble in my workbook “dirty paki”. The shame I felt for being brown, dressing differently and speaking languages other than English led to anxiety and a withdrawal during core schooling years. Unfortunately, these experiences are not unique to my situation. Countless young individuals unnecessarily hated and repressed a rich, beautiful and vibrant heritage during their formative years. The generation who migrated felt the brunt of the othering process, whilst another generation stands here today perhaps questioning why home does not feel like home at times? What are we? Who are we? If not here, where do we and to whom do we belong?

Prejudice and discrimination remain insidiously embedded in British society and can be found in housing, education, health access and job recruitment, retention and promotion. A recent YouGov poll reports that two thirds of Black Britons experienced racial slurs; three quarters had been asked “Where are you REALLY from?” and half believed their career development had been hindered. The Lammy, Timpson and McGregor-Smith Reviews identified and provided scrutiny of the practices that need review and reform with relation to racial disparities within the criminal justice system, school exclusion and directly relevant to us, race in the workplace.

Whilst the SAHM provides a rightful platform of celebrating the South Asian diaspora’s heritage and contribution to British Society, it must also become a platform recognising the sacrifices, losses and pain which were woven into narratives through the historical association with the British Empire. As individuals and institutions, we must strive for diversity, equality and true inclusivity in order to create not only a just workspace but a just society for the generations to come. By no means an easy path but most certainly one to celebrate.

I will gladly provide the original sources of factual information referred to in this blog, upon request.


In the loving memory of my self appointed editor, best friend, and cheerleader. Our very first conversation centred around inequalities, prejudice, and discrimination pertaining to gender and race. You continued to challenge the orthodoxy and status quo at every opportunity. Despite the darkness surrounding the limitations of the human condition…you continued to have hope in humanity. The world has lost a good human…and I have lost an entire world.

“The likelihood that your acts of resistance cannot stop the injustice does not exempt you from acting in what you sincerely and reflectively hold to be the best interests of your community”.
– Susan Sontag

Crises, whether they are economic, political, humanitarian, or as the current pandemic, health related – they test us. They test us as individuals, and they test us as nations. They test every fibre of our existence in our resolve to continue with a sense of normalcy in a construct where nothing remains “normal”.

The pandemic has challenged us in our professional and personal lives on a continuous basis. However, beyond the trials that we face as individuals, we face constant battles as a society. The legacies left behind, once this pandemic subsides, will be preserved by history. They shall remain a point of reference and learning for the future generations who will inevitably, at some stage, face pandemics of their own.

The suffering associated with Covid-19 is not restricted merely to economic and political fronts, rather, it has complicated the ethical and moral dilemmas associated with inequality and discrimination, specifically to this blog, race, and ethnicity.

There has been a global rise in the open racism and xenophobia targeted towards the Chinese diaspora who have been vilified and blamed for the spread of Covid-19. These incidents are not restricted to isolated individuals, however, recognised official institutions across the globe have been setting reckless and dangerous precedents through political speeches, religious rallies, and even within educational institutions.

Unfortunately, the model of blaming a specific group of people as disease vectors is not new. History is riddled with similar examples of this “othering” process. During the 14th Century Black Death, the Jewish populations were assaulted and ostracised; the Irish Catholics were blamed for the cholera outbreak in 1858 with hospitals for immigrants being burned down; the Chinese population in San Francisco was persecuted for the outbreak of smallpox in 1878. More recent examples include a prominent Congressman writing to the CDC in 2014 advising them that children from Central America imported diseases to the US; the vilifying of black people for the 2013 Ebola outbreak as well as the continued stigma associated with HIV/AIDs.

The danger with stereotypes is how they have historically informed discriminatory practices. For example; different screening procedures depending on one’s race or ethnicity, passing bills to prevent the entry of specific nationals across borders; and, denying access to education and healthcare.

Back to present day and the current outbreak – whilst our immediate professional priorities have been maintaining the safety of our patients despite daily trials of minimal PPE, lack of testing and limited resources – there remains an urgent need to constantly challenge the inequalities that this pandemic fuels on an ethical front – and the matter of race becomes crucial in this. The message we send has to be one of equality, inclusion, and rooted in collective humanity.


This article was recently written for the Meer-e-Karwan series. Several months have passed since I have been able to write and certainly life has passed since I was able to write something so personal and raw. My gratitude to Niharika who has kindly edited the editor! 

Here goes. 

Body image and society – personal trials and tribulations. 

Being bullied for my weight is the earliest memory I have of school. Being told that “you’re a fat tub of lard…” is my strongest memory of an interaction with a trusted relative from my formative years. Throughout my school years I hid in classrooms and libraries so I could avoid the verbal, sometimes physical hostility, from some of my peers. I was weak for I had not known what strength was. I was not empowered for I could not find my voice. I was lost for solutions because I hid what hurt me day in and day out.

So – when a little while ago I made a Meer Monday promise of writing something about body image, I had naturally considered the trajectory of childhood obesity, associated playground bullying and the challenges of social exclusion and discrimination manifesting into low self-esteem, anxiety and depression.

However, I am painfully reminded on a regular basis that the ridicule, bullying and victimisation has not ended on the concreted playgrounds of our educational institutions. It transgresses and follows us into our adult lives, work spaces, social spaces and worst of all, the havens that we call home and family.

So it stands to reason that we talk about all of that today. However, before we proceed, I would like to offer disclaimers. This extended monologue is NOT about the scientific reasons of obesity or indeed, any short-cut solutions. It is a narrative, which focuses on the effects of negative experiences pertaining to body image and societal reactions.

I have deviated from my usual clinical style of writing, which is succinct, factual and usually drawing upon statistics. Instead, there shall be an outpour of personal experience with the intentions of giving an insider’s view of what is wrong with and what needs to be focused upon in order to nurture a society, which can move beyond its stereotypes and prejudices.

I was at a wedding over the weekend and was reprimanded on an individual’s inability for “not recognising you…you have gained so much weight, how did you let yourself go?”, as well as being the comedic interval for some “Oh, so fat you have gotten, max lol” (then said individual proceeded to do a King Kong expression). The best ones are of course the aunties with the life changing advice of “Eat salads and go to the gym”. I could applaud such astute and gifted advice.

Some of them are even quite concerned about your life moving forward, “You know, if you don’t lose weight then you shall only get married to someone like you”. What? To a progressive liberal who has been emancipated through the culmination of his life experiences leading him to accept and love humanity based on the credentials of their personality, moral values and NOT their dress size? Thank you Aunty, I shall have one of them to go right now.

Not having a friend until college years challenged my concepts of healthy friendships and relationships. The longest running cognitive defect I have carried has been the lack of self-worth and believing that I do not deserve friends, do not deserve kindness and do not deserve love because of how I look. It was not until I was in Oxford that I found the most fundamental aspect of an individual’s social growth and progress – the facilitation of accepting of oneself wholly; recognition for the value of one’s existence and most importantly NOT being apologetic about it.

How did that come to be for me? I was lucky to find a group of friends who looked beyond physical appearances. They recognised me for what I had to offer regarding my values, ideologies and most importantly, the quality of friendship. They have fiercely challenged my biases against myself and reprimanded me against the unkindness I have shown myself.

The outcome of this is a thirty-one-year-old unmarried overweight brown female who values and believes in herself and her contribution to the lives of those individuals who are linked to her (oh, and she now has a tendency of owning the dance floor once she gets the moves going – thank you, Abhilasha).

The perceptive ones amongst you will have noted the references made to certain parameters of age, race and marital status. All of these are further examples of artefacts that have no real significance except being arbitrary descriptors, which are utilised to judge and draw an irrelevant correlation to the worth of an individual’s existence. Unfortunately, these artefacts will continue to plague individuals and their self-worth unless a conscious effort is made to alter this.

So where do we begin? Firstly, challenge yourself. Do you hold discriminatory values? Do you make jest of an individual’s personal features be it weight, appearance, mannerisms etc? Do you laugh at the fat jokes, black jokes, gay jokes, sexist jokes? Stop doing it and where appropriate (hint: appropriate at ALWAYS) make an apology for your decorum.

Secondly, identify bullying behaviour. Is this happening in your child’s school or playground? Is this happening in your home? Who is it happening to? How is this affecting them? Challenge such behaviour – do it with kindness but with assertiveness.

Thirdly, educate. I firmly believe that a moral education begins long before a child enters school, in the confines of their home and personal environment. Teach them about acceptance, kindness and eradicate archaic social concepts of what a right and wrong body should look like. Show them how to empower those who are broken and vulnerable. Enable them to create spaces of fairness and justice, where bullies are challenged.

Fourthly, challenge institutions. Schools, colleges and universities are sacred intellectual spaces. Their responsibility does not stop once the examination papers have been handed in. They are a key component in shaping the environment where individuals grow, develop their sense of personality and find their social standing. Arguably it therefore becomes our duty to ensure our intellectual spaces facilitate anti-bullying and anti-harassment policies. Expect these institutions, which have a moral and legal obligation to safeguard our children, to gather information of the social practices within their grounds and inform us about the experiences of our youth. Only then we can collectively attempt to make individual experiences better and not lead people down paths of doubt, low self esteem and broken morale.

An eighteen year old woman chronically raped by her father, brother and uncles since she was nine. 

A nineteen year old girl having chronic pelvic and genital pain secondary to genital mutilation in the name of culture, tradition and honour. 

A twelve year old girl child sold and married to a forty-two year old man in her village. 

A twenty-eight year old woman physically beaten on a regularly basis by her alcoholic husband. 

A forty year old woman kidnapped and sold to her former husband at the age of sixteen. 


These are just examples of women and female children whom I have come into contact with through my clinical practice, outreach work and in my social life. I have found these women in the emergency rooms, in psychiatric facilities, in the genitourinary medicine & contraception clinics. I have found these women not only as a doctor in the corridors of hospitals – I have found these women in the lanes of my life.

They all have been subject to violence. Violence against women takes place in several forms – physical violence by intimate partners, sexual harassment, sexual violence, female genital mutilation, trafficking, child marriages etc.

Although there is an increased awareness of the violence suffered by women and female children, we still live in a society where these crimes are horrifically rampant. We live in a world where a third of the countries have NOT outlawed domestic violence. We live in a world where 1 in 7 girls are married in Central and West Africa before they are 15 years of age. We live in a world where 1 in 2 women were killed by their partners and/or families in 2012. We live in a world where up to a third of adolescent women describe their first sexual experience as rape/sexual abuse. We live in a world where thirty-seven countries exempt rape perpetrators from prosecution if they are married or marry the victim after the event1.

The purpose of this article is to educate and discuss the nature of violence experienced by women, to understand the extent of the problem, and finally, what to expect from our health professionals and our governments.

The vast majority of the statistics and information is taken from the World Health Organisation and the United Nations websites, which I implore you to read. All of the factual information, which is present in this article, from the aforementioned institutions is listed at the end.

Background and definitions

Violence against women is a global public health problem and a violation of human rights. The United Nations defines violence against women as “any act of gender-based violence that results in, or is likely to result in, physical, sexual, or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life”-2

A 2013 analysis conduct by WHO with the London School of Hygiene and Tropical Medicine and the South Africa Medical Research Council, used existing data from over 80 countries and found that worldwide, 1 in 3 women have experienced physical and/or sexual violence by an intimate partner or non-partner sexual violence3.

Risk factors4

The risk factors for women experiencing intimate partner violence include low education, exposure to mothers being abused, abuse during childhood, attitudes accepting violence, male privilege and women’s subordinate status.

Equally, men are more likely to perpetrate violence if they have low education, a history of child maltreatments, exposure to domestic violence against their mothers, alcohol dependence, unequal gender norms, attitudes accepting violence and privilege over women.

Factors associated with sexual violence perpetration include beliefs in family honour, sexual purity, ideologies of male sexual entitlement and weak legal sanctions for sexual violence.

Impacts on health, children and socioeconomics

Physical and sexual violence against women has led to physical, mental, reproductive and sexual health issues of victims. Some of these include unwanted pregnancies, sexually transmitted infections and other gynaecological problems. Specifically, in pregnancies, the risks include miscarriage, pre-term labour and the babies being at significant risks related to low birth weight.

 Women exposed to partner violence are as twice as likely to experience depression; almost twice as likely to have alcohol use disorders; 1.5 times more likely to acquire HIV, syphilis, chlamydia or gonorrhoea and 16% more likely to have a low birth weight baby. Furthermore, 42% of women who have experienced physical/sexual violence at the hands of a partner have experienced further injuries as a result and 38% of all murders of women, globally, were committed by their intimate partners1,3.

Children who witness such violence can display behavioural and emotional disturbances as well as being at risk of being perpetrators of violence themselves. Intimate partner violence has also been linked with higher rates of infant and child morbidity and mortality3.

The social and economic costs include women being at risk of suffering isolation, not being able to work, losing wages, not participating in regular activities and being unable to care for their children.

Prevention and response5

There are a number of guidelines as to how health professionals can train, prepare and respond for issues in violence against women. These include:

  1. Providing women centred care – professionals offering first-line support when violence is disclosed i.e. empathy, non-judgemental attitude, privacy, confidentiality and access to relevant services.
  2. Identifying and caring for survivors of intimate partner violence – Professionals should ask about exposure to violence with the aim to improve diagnosis, identification and subsequent care. First line clinical care should include emergency contraception, STI and HIV with relevant follow up.
  3. Mandatory reporting of intimate partner violence to the police is NOT recommended. Professionals should offer support to report the incident if the woman chooses. It is important to know the legal framework of reporting in each state/country. Usually if an incident is to be reported, the professionals should NOT carry out an intimate examination.
  4. Training of healthcare providers – Adequate history taking, risk management, investigations and planning management should be done at a pre-qualification level.
  5. Healthcare policy and provision – Care for women who experience violence and sexual assault should be, where possible, integrated into existing health services as opposed to a stand alone service. In the UK, this can include presenting to a General Practice, GUM services and if required, A&E.

Prevention is a powerful tool and evidence base from high-income countries has suggested that advocacy and counselling improve access to services for victims and are effective in reducing violence. In low resource countries, prevention strategies that have shown some effectivity include programs that empower women economically and socially through a combination of microfinance and skills training related to gender equality; that promote communication and relationship skills within couples and communities; transform harmful gender and social norms through education6.

Legislation is another key aspect, which can help achieve change. There is a need to implement policies that promote gender equality by ending discrimination against women in marriage, divorce and custody laws; ending discrimination in inheritance laws; improving women’s access to employment and developing national policies to address violence against women5,6.

 References and further reading

  1. United Nations. Declaration on the elimination of violence against women. New York : UN, 1993.
  2. United Nations. Fact and figures: Ending violence against women. http://www.unwomen.org/en/what-we-do/ending-violence-against-women/facts-and-figures
  3. World Health Organisation. Global and regional estimates of violence against women. Prevalence and health effects of intimate partner violence and non-partner sexual violence. http://www.who.int/reproductivehealth/publications/violence/9789241564625/en/
  4. World Health Organisation. Violence against women and children: facts. http://www.who.int/news-room/fact-sheets/detail/violence-against-women
  5. World Health Organisation. Primary prevention of intimate-partner violence and sexual violence: Background paper for WHO expert meeting May 2–3, 2007
  6. World Health Organisation. Infographics: Violence against women infographic. http://www.who.int/reproductivehealth/publications/violence/VAW_infographic.pdf


Written as part of the Meer-e-Karwan series.

The purpose of this article is to discuss mental health, the issues of stigma and to signpost to some important resources and organisations.

Mental health problems are a significant contributor to the overall disease burden worldwide, with major depression being the second leading cause.

  1. 1 in 5 adults experience mental illness in a given year
  2. Mental health and behaviour illnesses are estimated to cause over 40 million years of disability in 20-29 year olds.
  3. In Britain alone; between 2003 and 2013, 18,220 people with mental health problems committed suicide
  4. I in 15 has made a suicide attempt in their life.
  5. 75% of young people with a mental health treatment are NOT receiving treatment
  6. The average wait for effective treatment is 10 years1-3.

The World Health organisation definition of health is “a state of complete physical, mental and social well being and not merely the absence of disease or infirmity.” Mental health in this regard refers to our emotional, psychological and emotional well being.

There are a number of mental health problems and they are multifaceted in their aetiology. For example, they can be caused by a combination of biological factors (e.g. genes, brain chemistry), life experiences (e.g. trauma, abuse) and/or family history of mental health problems4.

Physical and mental health are also not two separate entities as poor physical health increases your risk of developing mental health problems and individuals with mental health problems have a worse trends in morbidity and mortality.

Mental health problems can include depression, schizophrenia, post traumatic stress, learning and eating disorders as well as substance misuse and addiction. The discussion of these is beyond the remit of this article, and as such, we shall focus on the stigmatisation of people with mental health problems.

Society and Stigma

Despite the vast numbers of people affected by mental health problems, there is a huge social stigma and discrimination that is experienced. This stigma crosses barriers of countries, cultures and various creeds. Nearly nine out of ten people with mental health problems face discrimination and statistically we know that these groups face issues with finding work, being in a steady relationship, having adequate housing and being socially included in mainstream society2.

Mental health stigma can be divided into two types;

  1. social stigma – prejudiced attitudes and discrimination directed to those with mental health problem
  2. Self stigma – the internalisation by the mental health sufferer of their perceptions of discrimination, leading to feelings of shame and guilt5.

Stigma has three important aspects to it; stereotypes, prejudice and discrimination6.

  1. Stereotypes represent collectively agreed upon notions of groups of people and often include negative beliefs about mental health issues e.g. perceptions of danger, incompetence and character weakness.
  2. Prejudice is the endorsement of stereotypes and they involve a negative evaluative component, which can yield to emotional responses (e.g. anger, fear) to stigmatised groups. The power in prejudices can be seen when it turns inwards e.g. being at the centre of prejudice can lead to many persons not pursuing life opportunities for themselves.
  3. Discrimination is the unfair treatment of someone based on their mental health problems.

Strategies for changing public stigma

Broadly speaking, three approaches have been proposed to deal with social stigma; protest, education and contact7.

  1. Protest include challenging the inaccurate and hostile depictions of mental health, which can be found in media and public opinion.
  2. Education is the provision of information to individuals and groups in order to maximise their understanding and lessen negative stereotypes. A number of studies have shown that educational strategies have led to improved attitudes and reduction in the likelihood of discriminating8.
  3. Contact includes people with mental health disorders meeting those without, especially in the context of a social environment e.g. work. Research has shown that such contact events have led to decreased endorsement of psychiatric stigma.

What can YOU do?

Educate yourself!

Mental health issues are extremely common and unfortunately, so is the prejudice and discrimination against the people who are affected. The first step is always to educate yourself, and then to educate others. Knowledge is a powerful tool, which can not only help break down stigma, but also to help empower groups of people to come forward and seek the help they need, without the fear of perceptions. Below are some useful resources, which provide with statistics, have educational material and signpost to relevant groups for professionals, patients and the general public.



Time to change.


Social movement working to raise awareness of and ending stigma associated with mental health.



Mental health charity in England, which is working to procvide information and advice to those with mental health problems.

Mental Health Foundation


Improving lives of those with mental health problems and/or learning difficulties.

The centre for mental health


Organisation working to improve quality of life for those with mental health problems. A wealth of information and support links.

Depression Alliance


Information and support to those affected by depression.



Offering advice, relationship counselling, workshops and meditation.

Anxiety UK


Charity supporting those living with anxiety disorders including information provision, support and 1:1 therapy.



  1. Time to change. About mental health. https://www.time-to-change.org.uk/about-mental-health
  2. Mental Health Foundation. Mental health statistics: https://www.mentalhealth.org.uk/statistics/mental-health-statistics-most-common-mental-health-problems.
  3. Centre for Mental Health, UK. https://www.centreformentalhealth.org.uk/the-decade-of-delay
  4. World Health Organisation. Constitution of the World Health Organisation as adopted by the International Health Conference, New York, 19-22 June 1946.
  5. Corrigan PW. Understanding the impact of stigma on people with mental illness. World Psychiatry. 2002 Feb 1(1): 16-20.
  6. Corrigan PW. Mental health stigma as social attribution: implications for research methods and attitude change. Clin Psychol Sci Pract. 2000;7:48–67.
  7. Allport GW. The nature of prejudice. New York: Doubleday Anchor Books
  8. Roman PM., Jr Floyd HH., Jr Social acceptance of psychiatric illness and psychiatric treatment. Soc Psychiatry. 1981;16:16–21.
  9. Corrigan PW. River LP. Lundin RK, et al. Three strategies for changing attributions about severe mental illness. Schizophr Bull. 2001;27:187–195



“The clang of a spiked metal hammer falling with a thud on the pelvis, with jarred edges piercing the bone and grappling on.  The breathing soon becomes shallow and all motor function dies down until it is feasible to recalculate it and edge forward a few micro-movements, calculating every nuance of the body’s movement. On a good day, it feels like the muscles overlying the thoracic spine are being carefully, meticulously dissected with only the tip of a triangulated scalpel. On not so good days, the muscles are ripped apart with bare hands and without a care or concern of the well placed anatomy, each structure is torn out, discarded…until the prized possession is in view, the bone. Ruthlessly, it is smashed into a hundred pieces, ground amongst shards of glass and scraped at the pit of the physical being.

The cause of pain is not important, in fact, it seldom is. The cause is often a fragment of the prose, a minor detail. The protagonist (or antagonist) is actually the essence of “pain” and its superior ability in taking over your capacity to move, to breathe…to live. Every single day of your life. 

This, my friends, is pain…it forms part of one’s existence. Mirroring an ocean, it is deep, it is vast…it has many colours, it has many currents and beyond all, it has many creatures…some meek and mild, and some, purely satanic”.