The culture of shame

The context in which we are living now, every day multiple issues come up related to "Shame" and "honor" which affects clinical management of patients.

A girl admitted with suicide attempt on a ventilator tried communicating to us, writing on a paper - first note - please save my life, second note - please adopt me. The father seemed to be keen for her to be treated and looking forward to her recovery, but was not taking any efforts to pay the bills, or support in decision making, though they seemed to have the resources to support her treatment. The shame of having a daughter (though she is doing her BA) who has tried to commit suicide, was that why the father was aloof? Did the girl know that the honor of her family was at stake and that is why she did not want to go home?

Parents (both mother and father) when asked about the number of children they have - would blissfully say - 2 "bacha" and when asked again, how many girls you have, they will say - 5 bachi. This, kept away from us in our discussions unless specially asked for. Having too many girls, a matter of shame, not to be made known to treating health care professionals?

When girls are not brought to hospital for treatment or brought too late for treatment, is it because, the culture of shame of having too many girls has led to a culture of neglect and low value for life of women and girls?

The men who masks their contribution to the inability to conceive a child, and behaves arrogantly and tries to prove his "manhood" are they not carrying deep inside, the shame of not having their own children.

All these and many such issues of shame emerge from the cultural expectations. It is not only here where I work, but even where I hail from there are cultural expectations, and if not fulfilled there is the felt shame.

A study done few years back revealed that of the identified cases of honour killing over a period of time, most of these were from Pakistan Punjab (888), Jordan (23), Yemen (400) and India (5000).

Where do these cultures and expectations emerge from? A set of values, from which emerge these cultural expectations.

World values Survey done a few decades back across 54 countries and 64 societies looked at attitudes to family, gender, work, neighbor tolerance, democracy etc. and correlated it with corruption and other attributes. It was noted that societies with strong traditional and family values had more corruption and shame. Traditional societies that emphasize the importance of parent-child ties and deference to authority, along with traditional family values, and reject divorce, cross cultural marriages and suicide. But at the same time there is a powerful father, docile mother, no divorce, joint family context, and strict control over children.

Where do these values come from - from a world view which values people not as "Equal" but with differential values, based on what their world view teaches them. The understanding of the “image of God” is not part of the world view.

At the same time allegiance Family or Tribe supersedes values truth or God. In one sense God is replaced by family, tribe or even Nation. And thus values and truth which should emerge from God is replaced by allegiance to family tribe and Nation.

So what would it take to change these expectations - will literacy, inclusive development and or economic growth change these? Very unlikely - like God's own country where I hail from where we are 100% literate, economically doing well, dowry is an acceptable or even mandated...where boys come in with a price tag on them. Why has that not changed?

Change has to happen from inside, and where truth and absolutes values have to supersede allegiances to family, tribe or nation.

Will we see this in our generation? What do I do to facilitate this change?