SRINAGAR: It is like any other day at the valley’s leading gynecologist’s clinic: Crowded and packed with impulsive patients, who have come from different part of Kashmir to the summer capital, Srinagar.

For 17-year-old Maleeha, however, the day has brought anxiousness and worry. On her first visit to the doctor, Maleeha has been diagnosed of severe Polycystic Ovarian Syndrome (PCOS) which she fears will  make her infertile.

“I am extremely worried about this problem as it is known to cause infertility,” says Maleeha, who belongs to Baramullah.

Another patient, Andleeb, who has been married for six years, has been visiting the doctor for two years. She suffers from infertility, the cause for which remains unknown.

“I have got every test done but the doctors have not been able to find the reason for my inability to bear children. It has ruined my life,” she says.

Thousands of women in Kashmir are increasingly suffering from infertility. Couples are finding  hard to fight the problem which has saddened hundreds of families across the valley.

Leading gynecologist Dr Farhat Hameed says infertility is affecting the younger age group at an alarming rate.

She cites late marriages, hormonal imbalance, unhealthy lifestyles and stress as major reasons for infertility-related problems.

“The marital age for Kashmiri women has risen from 18-21 to 27-35 years. Girls prefer quality education and a good career before marriage. This has affected their child-bearing capacity,” Dr Farhat insists.

Studies at the premier Sher-e-Kashmir Institute of Medical Science (SKIMS) indicate 15.7 per cent women at childbearing age will never have an offspring without clinical intervention. A further 14 per cent of women are unable to conceive because of unknown medical conditions.

Dr Farhat added that conflict also gave way to infertility problems for women in the disputed region, due to increased stress levels.

“Conflict has resulted in many psychiatric  problems in women, including depression, Post Traumatic Stress Disorder (PTSD) and anxiety, which directly affect child birth.”

According to psychiatric research, 800,000 people in Kashmir – including women – are affected by PTSD.

The problem, once unknown in Kashmir, now affects 10 per cent of its female population, including teenagers and young women.

Gynecologist Dr Sameena says that PCOS is one of the most common disease affecting young women of Kashmir.

“The number of patients diagnosed with PCOS is adding with each day.”

PCOS is a major endocrine disorder which affects women of reproductive age. It is one of the leading causes of infertility across the world.

A SKIMS study of 112 young and adolescent PCOS women found that 65 to 70 per cent of them suffered from psychiatric illnesses, eight patients suffered from obsessive compulsive disorder (OCD), five had PTSD, and 27 were depressed.

Over the years, In- Vitro Fertilization (IVF) clinics have raised some hopes for childless women. Kashmir had none until 2003.

IVF procedures, however, are expensive. They cost between Rs.200,000 to 300,000, making them out of reach for majority of the population.

“My husband is a clerk  and does not earn much,” says Afsana. “We cannot afford IVF or similar treatments. I am reconciled to not having a child.”

Dr Farhat who runs an IVF clinic admits to the high costs but says “we do provide some concession to poor patients.”

Making things worse for the women are the social ramifications of infertility. Childless women are stigmatised and are looked down upon. Married women face the wrath of in-laws and husbands while unwedded girls fear marriage.

Such fear forces Tasleema Begum to take her 23-year-old daughter, Amber, to another district for infertility treatment to avoid being seen by her family.

“I do not want people to know Amber suffers from PCOS,” says her mother.  “Such things are not socially acceptable.”

Thirty-five-year-old Saima who is childless after four years of marriage is regularly abused. “Not a day passes when I don’t face abuse from my husband and in-laws for not bearing children,” she says.

“For me, the torture is two-fold.” The misbehaviour of in-laws hurts her more than childlessness.

“I am trying the best medication and doctors but the rest is in God’s hands,” she says. “Why should women be blamed for it?”

Many women are divorced over their inability to bear children, a trend common in rural areas.

The story about the health of women in Kashmir does not end here. Besides the sick reproductive health, the general health of Kashmir women is fasting deteriorating. Hypertension and orthopedic problems have become common.