​“Empathy is the only human superpower: it can shrink distance, cut through social and power hierarchies, transcend differences, and provoke political and social change.” - Poet Elizabeth Thomas. 

As a young mother, Dr Sana Younus*, an alumna and qualified child psychiatrist, was aware of Fatima’s pain. Fatima, mother to five-year-old Ahsan, exhaled deeply as she told Dr Younus about her recent encounter with the school principal. 

The headmaster began with the four words that every parent dreads hearing: “Your child isn’t normal.” 

Fatima knew what was coming next. Staff at Ahsan’s previous schools had also complained about his behaviour calling him rude and disobedient for avoiding eye contact and for flapping his hands during lessons. The principal echoed these concerns in the meeting. What no one had recognised was that Ahsan was showing symptoms of autism. 

“Due to limited awareness about autism in Pakistan, parents, family members, teachers and many a times doctors, are unable to recognise symptoms,” said Dr Younus. “This leads to the needs of these children getting ignored. In an attempt to increase awareness and to create an advocacy forum, I worked with my supervisor and mentor, Dr Ayesha Mian, and a dedicated parent to form APACT.”

APACT – short for Autism Parents in Action – is one of two initiatives championed by Dr Younus during her fellowship at AKU which led to her winning the highly competitive American Academy of Child and Adolescent Psychiatry’s Paramjit Toor Joshi, MD, International Scholar Award** that recognises young psychiatrists who enhance mental health services for children and adolescents in their local community. 

APACT is the first and only educational support group in the country for parents of children with autism. Its regular meetings at Aga Khan University’s teaching hospital in Karachi enable parents to learn from one another’s triumphs and challenges, and to understand how to navigate misconceptions about autism. 

“You can sense the relief a parent feels when they see they’re not alone and that others are facing the same challenges,” said Dr Younus. “It’s really inspiring to see parents who are so committed to making a difference in their child’s life. Forming a community like APACT is the best way to shrink the distance between ignorance and empathy that is so prevalent in society.” 

Each session, which is co-led by parents and psychiatrists, provides caregivers with vital information about the nature of autism and how to meet their child’s unique needs. Over 150 parents are a part of APACT’s Whatsapp and Facebook group where they share updates about their caregiving challenges. Between 15 and ​20 parents also attend its regular sessions.

Besides APACT, Dr Younus has also been working to address systemic issues that lead to many young children and adolescents like Ahsan never receiving the care they need, or receiving too little care, too late. 

Pakistan has just four trained psychiatrists for a population of approximately 100 million children. Since it takes years of training for a doctor to specialise in child psychiatry, this severe shortage of specialists is set to remain unless other paediatric professionals learn skills pertinent to managing children with mental health concerns.

Recognising this need, Dr Younus worked with her mentor, Dr Ayesha Mian, a board certified child and adolescent psychiatrist, to launch a customised certificate course to teach key issues in child and adolescent psychiatry to family physicians, psychologists, teachers, counsellors and paediatricians. 

The course covers major developmental, behavioural and mood/anxiety disorders and aims to grow the pool of professionals who can detect and support at-risk children. Now in its second year, the course has trained over 25 professionals who are now able to screen children for disorders, refer serious cases in a timely manner, and identify and protect children who are at risk of abuse or neglect. The training, which emphasises the importance of empathy, has helped professionals gain a new perspective into why young patients may not respond to ‘tried and tested methods’ such as counselling or medication that work with other patients. 

“Stigmas and limited awareness of such issues means that people can be quick to judge children or to blame parents for ‘unusual’ behaviour,” Dr Younus said. “My goal with these programmes is to sensitise society so that they turn this blame into compassion and learn to appreciate each child’s special needs. 

“Children like Ahsan have a right to achieve their potential. To make this possible we need to encourage society to acknowledge and accept difference and to learn when a child needs the help and attention of specialists.”