It's long been assumed that, in conservative Islamic societies, sex is a subject to be spoken about, if it's discussed at all, in guilty whispers.

Yet, for many months now, women in Pakistan have been dialing in to a TV show to ask about profoundly personal issues — live on air.

"I have to talk about my husband," said a woman who gave her name as Sonia on one of the show's recent editions. "His sperm count is very low ..."

She's on Clinic Online, a daily nationwide cable TV phone-in about lifestyle and health. Every Friday, the show offers on-air advice from a doctor about sexual problems.

The show was created by a Karachi-based broadcaster, Health TV, in an effort to explore new terrain in a market crowded by channels obsessed with cricket, Bollywood movies, soaps and above all, news and politics.

Clinic Online's target audience is female. It's broadcast at midday, when males of the household are usually out. The majority of callers are 30-something women, says Faizan Syed, Health TV's chief executive.

Although there's no reliable way of measuring ratings, the Friday show seems to be a hit. There are only two phone lines in Health TV's control room but, when NPR recently sat in on a broadcast, both were in heavy demand.

"The Friday show gets back-to-back calls. There is not a single break between calls," says Syed.

Questions About Infertility, And More

While calls are often from women worried about infertility, plenty of other issues also arise.

"One of the (recent) calls ... was about over-active desire," says Syed, "Basically the woman said, 'I'm not sure how to control this.'"

Syed says the doctor gave her medical advice but also told her to "turn to religion, turn to prayer and pray, and try to get through that moment."

"Yes, that is not a medical response, but let's not forget where we live," says Syed. "Our country is called the Islamic Republic of Pakistan."

Pakistanis do talk about sex. They have a rich supply of edgy jokes, and they also discuss it seriously.

All the same, it's a very sensitive and difficult area.

"You can only talk about it to your closest friends or a close family member, and even that's usually in the context of marriage," says Dr. Uzma Ambareen, a Karachi-based psychiatrist whose patients include people with sex-related problems.

Ambareen says Pakistanis are often wary about sharing their problems because they don't want to risk offending anyone's religious sensitivities.

"I think [religion] is a huge factor," she says, "Even masturbation is not considered acceptable. You never know what the other person's religious views are like, so people are often reluctant to discuss their own concerns. They're afraid of how the other person might respond."

Few Places To Go For Advice

Clinic Online allows Pakistanis anonymously to ask questions that they may be reluctant to take to their own doctors, partly because of cost, but also because of a multitude of quacks, offering useless and sometimes dangerous advice.

There's a privacy issue as well. In Pakistan, family members tend to insist on accompanying women to the clinic and even sit in on the session. Those who manage to secure one-on-one private time can find their doctors aren't great at keeping discussions private.

"I think that a lot of doctors may not take some of these things like issues of confidentiality and privacy very seriously," says Ambareen. "So if somebody is discussing something about themselves, [doctors] may actually mention it to a family member."

Violent Islamist extremists are a constant threat in Pakistan. So the makers of Clinic Online are treading carefully.

The show's presenter, Dr. Nadim Uddin Siddiqui, stresses that he's educating Pakistanis about issues crucial to their health and well-being, including the risk of sexually transmitted diseases and the importance of getting the right treatment.

"I am just making people get the treatment from the proper doctor, so I am saving the life of the people of my country," says Siddiqui.

Siddiqui's also doing something else: he's listening to women who often go unheard.

Faizan Syed, head of Health TV, says men tend to be reluctant to call in to the show. He cites "male ego," whereas women are more willing to take ownership of their family's sexual health issues.

"I think the women of Pakistan are actually some of the most powerful individuals you'll ever come across," he says. "Seeing these callers, I'd say most of them are not nervous. I mean, the women just need the opportunity to feel empowered, and they can do wonders."

Copyright 2015 NPR. To see more, visit http://www.npr.org/.

Transcript

STEVE INSKEEP, HOST:

If you ever get a chance to visit Pakistan and turn on the television, this is what you'll get.

(SOUNDBITE OF NEWS PROGRAM)

UNIDENTIFIED REPORTER #1: (Foreign language spoken).

(SOUNDBITE OF NEWS PROGRAM)

UNIDENTIFIED REPORTER #2: (Foreign language spoken).

(SOUNDBITE OF NEWS PROGRAM)

UNIDENTIFIED REPORTER #3: (Foreign language spoken).

INSKEEP: Lots and lots of news channels. The media have exploded in Pakistan since being freed up a little more than a decade ago. There's also plenty of this.

(SOUNDBITE OF CRICKET GAME)

UNIDENTIFIED ANNOUNCER: (Foreign language spoken).

INSKEEP: Cricket - and some of this.

(SOUNDBITE OF UNIDENTIFIED BOLLYWOOD FILM)

UNIDENTIFIED ACTRESS: (Singing in foreign language).

INSKEEP: To judge by what their networks deliver, Pakistanis are obsessed by news and by cricket and by Bollywood movies. Now TV channels are widening their scope into unlikely terrain. And we should warn you, this story contains language that may not be suitable for younger listeners. NPR's Philip Reeves reports.

(SOUNDBITE OF TV SHOW, "CLINIC ONLINE")

UNIDENTIFIED WOMAN: Hello.

UNIDENTIFIED MAN #1: (Foreign language spoken).

UNIDENTIFIED WOMAN: (Foreign language spoken).

PHILIP REEVES, BYLINE: This woman is asking a doctor about her husband's low sperm count. She's live on air across Pakistan, on a TV phone-in show.

(SOUNDBITE OF TV SHOW, "CLINIC ONLINE")

UNIDENTIFIED WOMAN: (Foreign language spoken).

FAIZAN SYED: I think what we are trying to do is make it OK and easy for people to call in and ask a question. And, you know, if you're anonymous and you can sort of step out of your character that you are and just really ask a question with an open mind and be like, look, I think I have this issue, what should I do?

REEVES: Faizan Syed is chief executive of Health TV, a private cable channel. Every day, his channel broadcasts a half-hour show called "Clinic Online." People can call in and ask a medical expert for advice. On Fridays, the show's about sexual health. Viewers always have a lot of questions, says Syed.

SYED: The Friday show gets back-to-back calls. There's not a single break between calls.

REEVES: You often hear people saying people saying sex is taboo in Pakistan. That's not quite accurate. Pakistanis do talk about sexual issues, but there are boundaries.

UZMA AMBAREEN: You can only talk about it to your closest friends or a close family member and, even that, usually in the context of marriage.

REEVES: Dr. Uzma Ambareen is a psychiatrist whose patients include people with sex-related problems. Pakistan's a conservative Islamic nation. Ambareen says Pakistanis are often wary about discussing sexual issues because of religion.

AMBAREEN: I think it's a huge factor. Even masturbation is not considered acceptable. You never know what the other person's religious views are like, so people are often reluctant to discuss their own concerns. They're afraid of how the other person might respond.

REEVES: Most of the show's callers are women. Their questions to the doctor are often about infertility, but not always, says Faizan Syed, head of Health TV.

SYED: One of the calls he got was about overactive desire, and it was from a woman. Basically, this woman said, I'm not sure how to control this.

REEVES: Syed says the doctor answered in medical terms, explaining why she's having these feelings.

SYED: And he also added that, look, you know, when you are facing this situation, turn to religion, turn to prayer and pray and try to get through that moment. Yes, that's not a medical response, but let's not also forget where we live. Our country is called the Islamic Republic of Pakistan.

REEVES: Violent Islamic extremists are a constant threat in Pakistan, especially in Karachi, where Health TV is based.

(SOUNDBITE OF TV SHOW, "CLINIC ONLINE")

NADIM UDDIN SIDDIQUI: (Foreign language spoken).

REEVES: The doctor who anchors the show on sexual health is Nadim Uddin Siddiqui. Siddiqui stresses that his show's educating people about subjects they need to know about - for example, sexually transmitted diseases.

SIDDIQUI: What I am doing - I am just making the people to get the treatment from the proper doctors, so I'm saving the life of the people of my country.

REEVES: You may be wondering why the women who call him don't just go and see their doctor. It's not as simple as that. There are a lot of quacks around. Also, here, family members tend to insist on accompanying women to the clinic and even sitting in on the session. If you do get some one-on-one private time, doctors aren't always great at keeping secrets, says psychiatrist Uzma Ambareen.

AMBAREEN: I think that a lot of doctors may not take some of these things, like issues of confidentiality and privacy, very seriously, so if somebody is discussing something about themselves, they may actually mention it to a family member.

(SOUNDBITE OF TV SHOW, "CLINIC ONLINE")

UNIDENTIFIED MAN #2: (Foreign language spoken).

REEVES: A man calls in to speak to Siddiqui. He's asking about fertility and about his sperm count. Faizan Syed thinks Pakistani men are generally more reluctant than women to phone in.

SYED: I suspect that. I think women, you know, sort of have more of a - you know, solve the problem, more inquisitive, more questioning.

REEVES: And what would be holding a man back from going on air like that? What would be the worry?

SYED: Male ego, I suppose.

REEVES: Women in Pakistan live in a society that profoundly restricts their freedoms, but do not underestimate them, says Syed.

SYED: I think the women of Pakistan are actually some of the most powerful individuals you'll ever come across, and that's a fact. And seeing these callers, I'd say most of them are not nervous. I mean, the women just need to be given the opportunity to feel empowered, and they can do wonders.

REEVES: Philip Reeves, NPR News, Karachi. Transcript provided by NPR, Copyright NPR.

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