Heal Pakistan: Two people wake up with the same kind of pain. Let’s say it’s the kind of pain that coils itself around your back every morning, a weight you can neither shake off nor explain. For one of them, the journey begins with a phone call to a private hospital and an appointment with a specialist the same week. For the other, the journey begins with “beta, yeh to normal hai” from a family member, followed by a six-month wait at an overstretched public clinic.
The two individuals experience the same pain, share the same human body, and reside in the same country, but their experiences are markedly different.
This is how pain works in Pakistan: not just as a medical condition but as a policy, a hierarchy, and a privilege. Pain is not treated equally here. Whether your suffering is believed or dismissed depends heavily on your postcode, paycheque, and even gender.
The Physical Pain Divide
Back pain? If you’re rich, you’ll probably get an MRI, a physiotherapy plan, and perhaps even a quick surgery if it’s serious enough. If you’re middle-class, chances are you’ll get a quick prescription for Panadol, a doctor’s shrug, and a reminder that everyone has thakan these days. For women, there’s the added dismissal: “Hormones ki wajah se hoga, har larki ko hota hai.”
Families play their role too. In many middle-class homes, acknowledging pain is itself a luxury. Aunties tell you, “Don’t be dramatic, Muscle pull hogya hoga” or “jao thori si walk krlo, sab theek hojayega.” The result? Conditions like endometriosis, slipped discs, and chronic migraines often go undiagnosed for years, while wealthier patients get timely interventions that prevent the pain from becoming permanent.
Pain, in other words, is not just biological. It is deeply political.
The Mental Pain Divide
The same double standard exists in mental health. In fact, it’s even sharper.
An elite’s stress is called anxiety. A middle-class person’s stress is reduced to “tension”. An elite’s sadness is diagnosed as depression. A middle-class person’s sadness is waved off as “deen se doori” — a spiritual weakness, not a psychological condition.
Therapy is a normal word in elite drawing rooms: “My therapist said this; my therapist said that.” In middle-class homes, ‘therapy’ is practically a forbidden word. It’s whispered, stigmatised, and treated as proof that you’re either “pagal” or spoilt. The irony is that the people who often need therapy the most — the ones juggling financial pressure, job insecurity, and social obligations — are the very ones discouraged from seeking it.
Gender further complicates the situation. Women who cry too much are told, “Sabr kro, dramay naa kro.” Men are told, “mard bano, strong raho.” In both cases, the actual suffering is erased under cultural clichés.
Pain as a Privilege
What ties both physical and mental pain together is this: whose suffering is allowed to exist, and whose is brushed away.
If you have money, your pain is clinical, diagnose, and treatable. If you don’t, it’s exaggerated, spiritual, or imaginary. If you’re rich and can afford therapy, your mental health is “important”. If you’re not, your sadness is weakness, and your stress is a lack of faith.
Untreated pain, whether physical or mental, can trap individuals in unbreakable cycles. Chronic back pain can cost you your job. Untreated depression can spiral into dysfunction. And once you lose work, your financial stability collapses, making treatment even less accessible. Pain becomes not just a symptom but a class marker.
Why This Matters
We like to pretend that health is universal, but in reality, it is profoundly unequal. The way pain is diagnosed, labelled, and treated reveals the truth: our healthcare system and our social attitudes are designed to prioritise the suffering of some while silencing that of others.
And here’s the hardest truth of all: pain does not discriminate. It doesn’t care about your bank balance or your address. However, our policies, hospitals, and even families discriminate based on these factors.
Conclusion
I have seen this up close. I have seen how people with private insurance get sympathy, scans, and solutions, while others are told to “be patient” or “have faith.” I have seen how young women are taught to live with cramps and migraines as if they are destiny, not disease. I have seen how middle-class boys and girls are discouraged from saying the word “depression” out loud, as if naming it will make it shameful.
Physical pain matters. Mental pain matters. And healthcare — whether for the spine or the soul — should not be a privilege reserved for the elite.
Because in the end, pain is universal. But the way we treat it is not.
