Three of the world's mightiest mountain ranges, the Hindukush, the Karakoram and the Himalaya adorn the forehead of Pakistan. Thirty-five formidable peaks over 24,000ft (7,315m) make the region a climber's paradise, inspiring a Pakistani writer to proclaim, "In Pakistan's lofty mountain regions, reaching for the sky doesn't seem too ambitious".
Yet 48 million people struggle daily on US$2.00 or less. Reaching beyond that is only a dream.
Pakistan's majestic fortresses bear witness to a country in deep poverty, where more than a third of children under five are underweight. A shocking 30-35 women die everyday from pregnancy related complications. Half the population is illiterate and more than 40% of the population is under 15.
 Pakistan is ranked 142 on the Human Development Index, compared to India 118 and Uganda 146. United Nations Development Programme. |
Unlike the mountain tribes who live a land-locked existence for most of the year blissfully unaware of the world beyond, Pakistani children face daily hazards related to child labour, violence and trafficking.
An estimated nine million children do not attend school. Only 51% of girls attend. Nine out of 100 children die before they reach their first birthday.
HIV/AIDS infection rates are burgeoning amidst acute unawareness, inadequate surveillance and voluntary testing and unsafe medical injection practices.
An estimated 62% of Pakistan's three million refugees are under age 18. Daily struggles are compounded by natural hazards like flooding and landslides, which always hit the poor hardest.
Authorities are actively engaging with humanitarian agencies like World Vision to address the causes of poverty and suffering. Challenging, yet not insurmountable obstacles stand in the way of the summit, and for the Pakistani people, one step closer to the sky….
| Area: |
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803,940 sq km (slightly less than twice the size of California)
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| Location: |
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Southern Asia, bordering the Arabian Sea, between India on the east and Iran and Afghanistan on the west and China in the north |
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| Major religion: |
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Islam |
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| Natural hazards: |
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Frequent earthquakes, occasionally severe especially in north and west; flooding along the major rivers after heavy rains and melting snow (July and August) |
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| Population: |
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152.53 million in 04 - 05 (Economic Survey 04 - 05) |
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| Age of population: |
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0-14 years: 39.6% (male 33,104,311/female 31,244,297)
15-64 years: 56.3% (male 46,759,333/female 44,685,828)
65 years and over: 4.1% (male 3,189,122/female 3,437,055) |
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| Form of governance: |
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Federal Republic |
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| Human Development Index: |
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142 compared to India 118 & Uganda 146 |
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| GNP per capita: |
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US$470.00 compared to Angola US$740.00 |
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| Life expectancy at birth: |
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63 |
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| Under-five mortality rate: |
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103 per 1,000 live births, compared to 93 in Sudan and 87 in India |
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| Infant mortality rate (under 1): |
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81 per 1,000 live births, compared to 63 in India & Lesotho
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| % of children in child marriage (total): |
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21% |
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| Adult literacy rate (over 15): |
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43% |
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| % of population living under US$1 a day (1992-2002): |
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13% |
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| Net primary school enrolment/attendance: |
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56% |
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| Unemployment: |
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8.3% plus substantial underemployment |
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| % annual central government allocated to health*: |
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1% |
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| % annual central government expenditure allocated to education*: |
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1% |
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| % annual central government expenditure dedicated to defence*: |
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15% (3.1% of GDP- 05 & 06 budget) |
Source: State of the World's Children 2005 & UNICEF website
* 1992-2004
For Pakistan's children, poverty means so much more than just lacking material things.
It means they are more likely to find themselves working on the street than thriving in the classroom. They can't choose whether they marry at the age of 13 or choose not to prostitute themselves to survive. They are powerless to the wrongs that are committed against them.
An estimated 1.2 million children live in Pakistan's cities and urban centres working 12-15 hours daily. Between 5,000- 6,000 children are behind bars in 75 jails across the country. Most are there because of petty crimes. They are treated as adults and afforded little protection from abuse.
More children under the age of one die in Pakistan than in India or Lesotho.
Unemployment, swelling family size and social disintegration seen in abuse in schools, as well as domestic violence, neglect and family breakdown threaten the well-being and very survival of children across Pakistan.
Pakistan's major cities and urban centres are home to an estimated 1.2 million street children. These include children as young as four who beg and scavenge around rubbish dumps or industrial waste sites or take on menial jobs as cart pushers or dish washers. They work 12-15 hours a day to earn around 75 rupees or US$1.25. If they are fortunate their takings will buy them a meal.
Few children find justice on the street. Boys and girls are fair game to pimps and others who would force them into stealing, scavenging and smuggling to survive. A large proportion sniffs cheap, readily available solvents to starve off hunger, loneliness and fear. Children are vulnerable to contracting sexually transmitted infections, including HIV/AIDS, as well as Tuberculosis, Jaundice and liver or kidney disorders.
| If we don't act now, they will constitute another lost generation". Sigurd Hanson, World Vision Pakistan National Director |
"World Vision is acutely aware that these children desperately need protection, care and a sense of belonging. We are committed to making this a national priority. If we don't act now, they will constitute another lost generation", says World Vision National Director Sigurd Hanson.
Eleven-year-old Yousaf is from inner city Lahore, commonly known as Gawal Mundi. He ekes out a living by cleaning car windows and windshields at traffic lights. Yet cleaning is just a cover to beg for a few coins to buy a meal. For variation he sometimes washes cars outside large shopping centres and markets. The pattern is always the same- 12 hour working days, leftovers or poor quality food sold off the street, shelter anywhere that is dry and out of sight. Abuse is a given.
According to a United Nations Office on Drugs and Crime (UNODC) survey, 72% of working children do not have contact with their families and 10% have no knowledge of their families.
Yousaf fled his hometown "Sailkot" after his father beat him. For this 11-year-old going on 31-year-old, the street is home. He has no secure income and his earnings fluctuate daily. When he becomes ill Yousaf scrapes money together to buy imitation painkillers in the market, usually produced by false manufacturers.
| "72% of working children do not have contact with their families". United Nations Office on Drugs and Crime. |
Some time ago amidst a spontaneous thunderstorm Yousaf sought shelter in a police van. Once inside, four police officers sexually abused him. Yousaf has no hope of seeing justice served.
More than 100,000 child scavengers or rag-pickers can be found across Pakistan, according to the International Labour Organisation. They are exposed to scabies, malaria, dysentery, anaemia and muscular problems, as well as to chronic diseases like Tuberculosis, jaundice and liver/kidney disorders. Exposure to cast-off syringes puts them at risk of contracting infections like HIV/AIDS.
| ...Scavenging has been his life- he has known no different |
Omar is from the gypsy community of Lahore, Pakistan's second largest city. At just ten, Omar has four years experience of "professional" scavenging for 10-12 hours a day. His work returns little so he eats what he finds. He spends three or four nights on the street in various locations and returns 'home' when he can.
Omar doesn't go to school and seldom spends time playing with friends. Tired or sick, Omar works. Time is a precious commodity that he uses to scavenge scrap metal and other goods for his employer. Although he has no fixed salary, Omar says that he has contributed to marginally improved conditions at home. He recounts experiences of physical and verbal abuse by his employer, but scavenging has been his life- he has known no different.
World Vision planned response:
- Set-up drop-in centres in Lahore and Rawalpindi in the Punjab Province and Peshawar in the Northwest Frontier Province where especially vulnerable children can receive a daily nutritious meal, a bath, medical care, psychosocial counselling and informal education.
- Establish and build the capacity of referral services to secure safe accommodation for extremely destitute children and where possible, support families so that children can return to the home and go to school.
- Establish rehabilitation and skills training centres in Rawalpindi and Peshawar where older children will acquire marketable skills through training and apprenticeships to enable them to earn a decent living wage to support themselves and their families.
- Provide legal support to women and children in prison.
- Generate income for vulnerable families by providing livestock such as chickens, lambs and goats.
- Implement a comprehensive, long-term programme initially focusing on advocacy, raising awareness of children's rights, HIV/AIDS awareness, prevention and referral for treatment.
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At least 200,000 women and girls have been trafficked to Pakistan from Bangladesh and Central Asian countries for commercial sex and domestic work in recent years. Estimates suggest at least 300 children are trafficked to the Middle East every year for use as camel jockeys. In some cases parents sell their children for monetary gain.
Girls and women from rural areas are trafficked to Pakistan's urban centres for forced commercial exploitation or bonded labour. Pakistan is also a renowned transit route.
Promising a better life, these 'traders in flesh' are the only ones to gain from the bargain. Instead of better food and protection, they experience sexual violence, beatings, torture, illegal confinement and denial of their identity and freedom.
| Thirteen-year-old Shahida from Chitral first met her 40-year-old husband in Lahore. He promised her a fine life and gave her father a substantial dowry. But Shahida was not a prized bride. She was among many other women who casually frequented the home. Initially, her family would not take her back, but at 18 and after five years of unhappy marriage and three children, Shahida returned to Chitral and resumed her education. She left the marriage and her childhood behind. |
The United Nations Development Programme's 2004 Gender-related Development Index ranked Pakistan at 120, on a scale of 177 below India and Bangladesh.
Forced marriage is becoming more acceptable for debt release or because of dire poverty, especially in the North West Frontier Province (NWFP). In Chitral, Walwar, or bride price has become more of a business transaction where fathers sell their beautiful, under aged daughters to older men from different provinces, particularly the Punjab.
| …Bride price has become more of a business transaction where fathers sell their beautiful, under aged daughters to older men from different provinces, particularly the Punjab |
In Pakistan, rape or forced prostitution cases prosecuted under the Islamic Hudood ordinances require a woman's testimony, which is admitting adultery if she lacks proof or the testimonies of four adult Muslim men who witnessed the assault.
Underreporting, the inability of women to access the judicial system, as well as their limited economic and social capacity remain prime obstacles to counter trafficking in the country.
Working with local and international partners, World Vision plans to:
- Raise awareness on human trafficking, particularly of women and girls and to build the government's capacity to prevent trafficking and prosecute offenders.
- Conduct rapid assessments in the NWFP and Punjab provinces, as well as in Afghan refugee camps near the border to produce comparative analyses and design a comprehensive, long-term anti-trafficking programme.
- Air advertisements and facilitate talk shows, seminars, school activities and workshops for parliamentarians, district level administrators and humanitarian organisations to raise awareness and strengthen advocacy efforts.
- Train low-level law enforcement and border control personnel, prosecutors and judges to recognise and appropriately respond to trafficked persons.
- Work with partners to expand and strengthen victim and witness support and advise on re-drafting relevant legislation.
- Support shelter programmes that offer socio-psychological counseling, vocational skills training and micro-enterprise development opportunities.
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According to UNAIDS, Pakistan is on the brink of a widespread HIV/AIDS epidemic.
A third of Pakistani truck drivers recently surveyed had never heard of condoms and 19 out of 20 who bought sex from women did not use condoms, according to UNAIDS. Surveys among Commercial Sex Workers also reveal limited understanding of safe sexual practices.
Studies also indicate that 94% of Injecting Drug Users use dirty syringes. Use of unsterilised needles in medical care is also widespread.
| "Pakistan's HIV infection rate is comparable to South Africa fifteen years ago. Now is the time to deny the virus a firm foothold". Sigurd Hanson, World Vision Pakistan National Director |
Pakistan's 'bubble' burst when an outbreak was reported in its southern Sindh province. All of a sudden, the virus no longer belonged to just migrant workers.
Stigma, denial, poor surveillance and voluntary testing, as well as a lack of knowledge among the population, practitioners and policy-makers is contributing to under-reporting and burgeoning infection rates.
The World Bank reports heterosexual transmission accounts for about 63% of reported cases, exposure to infected blood or blood products for about 7%, male to male sex for about 5%, mother to child transmission for about 3% and injecting drug use for about 1%. The remaining 21% is unknown.
| "To date, the majority of infected cases are among males, with a female ratio of seven to one, a ratio that is expected in the early stages of an HIV epidemic". World Bank. |
High prevalence of Thalassaemia, a hereditary blood disease, as well as Hepatitis B & C is increasing due to unscreened blood transfusions. Prevention and safe treatment of these diseases is therefore inextricably linked with the prevention of HIV/AIDS.
Working with local and international partners, World Vision plans to:
- Build capacity on federal, provincial and local government levels, as well as among humanitarian organisations, especially in the NWFP and the Punjab.
- Design and implement a countrywide programme that addresses gender inequality, poor education and social disintegration that are both the cause and effect of dire poverty.
- Raise awareness about other infectious diseases such as Hepatitis B & C.
- Raise awareness about Thalassaemia and the safe use of injection materials and blood screening.
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An estimated nine million school-age children are out of school in Pakistan- 5.9 million of them girls.
The average enrolment figure of girl students in three districts of the North West Frontier Province is just 37%, according to the latest provincial government figures. Less than 50% of girls finish school.
Uneducated girls tend to marry early and bear more children, who are likely to be among the nine out of 100 children who die before they reach their first birthday. Without an education, girls have limited choices and little chance of earning a stable income. They are less aware of HIV/AIDS and other infections such as Hepatitis A & B. The uneducated girl is more vulnerable to abuse, exploitation and disease.
Malnutrition among school-age children, especially girls is widespread in rural areas due to deficiencies in their diet. Girls who attend school often struggle to concentrate and perform well due to poor health and lack of energy.
| The uneducated girl is more vulnerable to abuse, exploitation and disease. (UNICEF) |
Large family sizes, gender discrimination, low income and the prevalence of child labour combine to keep girls out of school in Pakistan. Losing out on education means girls lose out on their basic rights and chance to be the best they can be.
World Vision proposes to increase enrolment of girls in school and improve nutrition by:
- Providing girl students with cooking oil as an incentive
- Supporting female education, including health education
- Improving food security for vulnerable groups within communities
- Supplementing the nutritional intake of infants and their mothers
The programme will assist 20,000-25,000 girl students during the first year of the project and 40,000-45,000 in year two. It aims to assist an estimated 12,000 infants and their mothers.
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More than three million Afghans still remain in Pakistan according to a recent United Nations High Commissioner for Refugees (UNHCR)-funded population census. About 1.8 million live in the North West Frontier Province both in refugee camps and in urban areas. Most lack assets and skills and fear returning to an unfamiliar Afghanistan empty-handed.
An estimated 62% of the refugees are under age 18. Many were born and raised in Pakistan. Most have received some level of education in Pakistan's refugee camps but UNHCR budget cuts mean around 20,000 Afghan refugee children could be denied a primary school education from 2005.
| While the needs of refugees are great, it costs just US$36 a year to give a refugee child an education. United Nations High Commissioner for Refugees |
Limited staffing means classroom sizes will swell, reducing the quality of education. Alternatively, Afghan refugee children will attend religious seminaries, whose credentials are not accepted in either Pakistan or Afghanistan for gainful employment purposes or they will be forced to beg, steal, work or prostitute themselves.
The Government of Pakistan and UNHCR recognise the importance of education to equip Afghan children with knowledge, skills and a sense of self-worth so that they can face the harsh and difficult task of returning home to rebuild their lives and country.
Repatriation and resettlement of families is also largely dependent upon economic opportunities inside Afghanistan. For most, prospects are bleak.
World Vision proposes to:
- Identify groups of Afghan refugees who are economically productive in Pakistan but who risk loss of income in Afghanistan.
- Provide skills training and access to loans that will enable families to create viable microbusinesses in Afghanistan.
- Facilitate repatriation and settlement of refugees by integrating groups into emergency employment and resettlement programmes in Afghanistan via partner agencies.
- Identify 'Refugee Impacted Areas' within Pakistan and explore ways of employing World Vision's 'Area Development Programme' approach to address issues in these areas.
- Facilitate the process of securing donor funding for Basic Education for Afghan Refugees (BEFARe), to help educate refugee camp children within Pakistan during the UNHCR funding crisis.
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Some two million people were affected by flooding and landslides caused by heavy rain and snowfall during January and February 2005 in Pakistan. More than 425 people were killed and 40,000 acres of land under cultivation was destroyed. Houses, roads, schools and hospitals were severely damaged.
Heavy torrential rainfall during the monsoon season (June to September), and melting snow in the north cause frequent flooding in Pakistan. The Punjab's major rivers, including the Jhelum, Sutlej, Beas, Ravi and the Chenab often flood surrounding plains and in doing so wreck havoc on irrigation and drainage canals, electricity and telephone lines, road links, bridges and other infrastructure.
It is estimated each major flood costs the country almost US$60 million in lost lives and livelihoods.
| Rapid urbanisation and population growth impact the frequency and devastation of flooding in Pakistan. Lack of economic resources on the family, local and national level also contributes to widespread vulnerability to flooding and family crisis as a result of flooding. Action Aid. |
Farming families are often the hardest hit. According to Action Aid, most farmers do not have the expertise, time or funds to properly manage their water resources. "These farmers are so poor they cannot even repair their own homes, let alone find money for lining canals", revealed its recent survey.
| These farmers are so poor they cannot even repair their own homes, let alone find money for lining canals. (Action Aid) |
Risk of landslides across Pakistan's hilly terrain is increasing due to soil erosion caused by heavy snowfall and frequent rains early in 2005. Rising June temperatures increase the probability of rapid snowmelt and ensuing flooding.
World Vision is working with the United Nations Development Programme (UNDP) and government departments to improve the coordination of relief responses in the monsoon season.
In anticipation of even greater flooding in the NWFP and Punjab provinces, World Vision is preparing to work with local and international partners to:
- Procure and distribute essential relief supplies, including food rations, kitchen utensils and medicines to 5,000 families in the most affected districts.
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World Vision is building relationships with local and international organisations and the Pakistani authorities to develop and implement long-term, sustainable programmes that address the root causes of poverty.
Interventions to alleviate poverty must be applied on local, regional and national levels. They must build trust, and empower, equip and encourage the people of Pakistan to be active agents for change.
World Vision Pakistan is now seeking funding to respond in the areas of children in crisis, trafficking, HIV/AIDS, education, Afghan refugees and disaster preparedness.
If you would like to help Pakistani girls get an education, protect children from trafficking and offer families a hand up in time of crisis, please contact:
Rebecca Lyman,
Regional Communications Officer & Web Content Coordinator (Australia based)
Email: rebecca_lyman@wvi.org
Phone: + 61 8 8528 2347
Project proposals for each planned response are also available via Rebecca Lyman.
Photos provided by Luke Powell, Kevin Cook, Greg Low, Terry Madison, Xabier Mikel Laburu, GODH Foundation and World Vision Pakistan.
Anecdotal information provided by GODH Foundation & World Vision Pakistan.
Feature by Rebecca Lyman, World Vision Middle East/Eastern Europe Regional Communications Officer & Web Content Coordinator.
Figures & statistics from the State of the World's Children 2005, UNICEF, UNDP & World Vision Pakistan.
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An estimated three in ten children in Pakistan are engaged in some form of labour. They include girls like Sonia, an 11-year-old domestic worker from a remote district near Kasur, a town located 40km from Lahore. 
Like her parents and siblings, Amna begs to earn enough money to put food on the table twice a day- if they are lucky. She doesn't go to school and the only time she spends at home is at night when she returns to sleep after begging on the street for about 14 hours. When Amna was asked whether she had ever been mistreated she began to cry and couldn't bring herself to describe her experiences. 