A couple of years ago, I visited the only Jewish graveyard in Karachi to photograph it for someone’s research.
This graveyard that once held 5,000 graves lies right opposite the Mewa Shah Graveyard around the Haji Camp area. Today, there are apparently only 300 graves that have survived. The caretaker told me they try to keep the entrance that bears the Star of David hidden from the general public by throwing an old cloth over it. He doesn’t want to draw attention of the Muslim mourners towards an already controversial and slowly deteriorating place.
I had permission to photograph the final resting place of some of the last Jews to have lived in Pakistan. Many of the tombstones are in Hebrew, but some have English poems and notes remembering loved ones.
“Life’s Race Well Run Life’s Work Well Done Life’s Crown Well Won Now Comes Rest”
“A light from our house has gone A voice we love is stilled A place is vacant in our home Which never can be filled”
The age when they died were mentioned. Professions were mentioned. Who they left behind were mentioned. Standing there, I couldn’t help but imagine their lives with the bits of information on these tombstones. I found it sad and yet fascinating;
What history this city has! So diverse and rich and how unfortunate that so much of it is falling apart and under perpetual threat of disappearing forever.
Right around the time I photographed the cemetery, well-known architect Arif Hasan had proposed this site officially be declared protected heritage by the provincial government. Though that never happened, the good part is that God is still is protecting this site from the qabza mafia perhaps thanks to the prayers of that one lady who still makes an annual trip from America to visit her grandmother’s grave.
Heritage is important. Roots are important. Ancestry is important. It’s essential to understand the past, dissect it and really look inwards in order to carve the future. We don’t do that enough or honestly in Pakistan. I often wonder where are we headed when there is such little reflection.
In 2018, I was commissioned by an organization to visit Edhi Centre’s in Karachi and collect stories about the people who worked there and how they ended up in their jobs. Here are some of the inspiring individuals I interviewed and photographed.
Shehzad’s Story
There are swings outside the Edhi homes that sometimes have babies in them. Babies no one wants to keep. Babies who cry and cry till a kind soul come out and takes them in. I know this because, a long time ago, I was one of them.
Growing up in the Edhi homes, I became their family.
I was loved and encouraged. The focus was never on the hands I did not have; it was on all that I did have. How can you not flourish like a well-watered tree with that kind of unwavering support?
You should see me today. I can do it all.
I am part of the organization and logistics management at the center. A lot of my skillset involves doing tasks that, at one time; no one imagined I could do. I can read, write, answer calls and book appointments as part of my job and I do this with both ease and pride.
I have come such a long way simply because I had people around me, who saw me as a human being, smart and caring, not just someone born without hands. They did not give up on me because of a disability, instead they thought to further the part of me that could overcome it.
We see so much of a harsh reality at the center that it is easy to lose hope and feel like there is no one out there who wants to help. It’s at times like that I want to tell people LOOK AT ME. See who I was, unwanted and alone, and look at what I have become, an individual with merit and something to give back. With people who are committed to changing others’ lives, who look at all humans as having potential and possibility, I really do believe that anything is possible. After all, I am the living proof of it.
Ilyas’s Story
One of the biggest constants in life is that it is completely unpredictable. You can have everything one minute and nothing the next and with the winds of change, people change as well. And nothing shows you the harsh reality of a statement like that than working at a place like Edhi centre.
I have worked here for 25 years and in all my years and all my positions from pharmaceutical to ward in charge to now managing this center, I have seen thousands of heartbreaking stories but there are some that just don’t leave you. These are the sudden events, when people from respectable well off families encounter life changing circumstances which leave them mentally or physically compromised and they are left here by family or strangers or well-wishers because they simply cannot be handled anymore. It truly humbles you to see that no matter who you are or what you have achieved or been careful to avoid, life is life and can bring you to your knees within seconds.
It takes a particular sort of person to be able to work here at Edhi. It’s not a job you choose; rather it’s the job that chooses you. Just anyone cannot do it. Look at me. I exist solely for this place now. Give me a holiday and watch me become anxious after barely a day has passed. I can work 12 hours and it feel like minutes, because once you start trying to help the people who walk through the door, you get drawn into wanting to make things better. And there is no end to that kind of work.
What we do requires commitment, empathy and more than anything else, a passion to continue to make right things in some small measure, for all the people who rely on us. I don’t believe it is something that you can necessarily learn; I think this gift of wanting to help is God given because I have seen so many people come here to work, but barely last a day in this environment. The people who stick it through, they are made of more and they will manage to do more- helping to make better the lives of those who have nowhere else to go.
Mohammad Aslam’s Story
We all live a certain way, moving fast and forward, until one day, suddenly, our life is transformed. Everything changes, and you have to find your way back again to what makes sense to you.
Growing up, I saw my father always take out time from his schedule for social work. He said that helping others brought him deep happiness.
At that time, while somewhere in my head and heart I am sure I knew the value of giving back, I was too immersed in moving ahead, in the busy life of earning money and chasing steps in my corporate career.
And then, the accident happened. Within minutes, nothing was ever the same again. Almost 75% of my body was burned away, leaving me exposed and vulnerable and as I would later discover, brand new.
Being away from Pakistan, stranded in Dubai where the incident took place, and the long interminable year of treatment and healing ensured that the person who emerged was someone very different.
Something in my very soul had shifted and I knew with utmost certainty that I could not live a life centered around only myself anymore. The urge to make a difference, to somehow help those who were needy, was overwhelming and I arrived at Edhi Sahib’s doorstep, without a plan, without an idea or any consideration regarding job or salary- just armed with the heartfelt desire to make things better for others. The rest, I had faith, would work itself out.
They say that the ability to be able to help anyone out, even in the smallest way possible, is a sign that God has blessed you; given you a second chance to truly understand the purpose of life. And as I spend my days here, earning my blessings, I can say with complete surety that the deep happiness and true satisfaction that I feel every day, far outweighs anything that I earned before.
Shahid’s Story
Have you ever witnessed pure love for humanity- a kind of service and giving back that is not tethered to any return or payback? If you haven’t, you have missed out on life.
For 16 years I worked as a computer lab manager in the army. My life was routine and structured and I was trained to manage, deal with and solve problems that came my way with focus and alone. After retiring I decided a change was needed and I joined the Edhi administration. My job initially involved organizing timely food dispatch to centers, organizing of patients into the relevant care centers, managing the ambulances and various maintenance duties. Eventually, as I grew into my new calling, I moved into admissions, taking on the responsibility of admitting new patients and starting their registration processes.
You don’t realize when the whole idea of giving back seeps into your psyche. One minute you are doing your job almost automatically and the next you realize that witnessing everything that people go through and being there to help them has changed the very core of you.
I remember this one time so clearly. I admitted a Professor who had come in from Dubai. He was so clearly in anguish. His son had died in a car accident here and because it was exam time, he had been unable to take leave from where he was teaching to be here for the funeral. He was struggling with depression and in the midst of a nervous breakdown.
Once you have seen the kind of trials people around you are going through, you develop a kind of inner peace. You worry about nothing worldly. You cannot take stress about small things because your life is now about being there for those people who are in such dire need of support and help.
Really if you don’t love all humans unconditionally, this job isn’t for you. I hope to stay working for Edhi till it is time for me to leave this world.
Sharoz’s Story
“I was 12 years old when I saw a man get hit and thrown off his motorcycle. The impact was strong and he flew in one direction, his bike in another. Most of the crowd ran towards the bike because they couldn’t see where he landed. I however, couldn’t keep my eyes off him and ran straight to him and tried to pick him up. Edhi Sahab, whom I had grown up watching on television, directly inspired my actions. He was so dedicated and selfless and I made up my mind that this was what I wanted out of life too.
I had always been a sensitive child, and rather than hardening me, growing up made me more acutely aware of what I could do to make things easier for others. Watching hardship – old people struggling in the heat to make ends meet hits me hard and to this day, I silently pray that one day I have enough means to make a real difference.
7 years ago, I quit my job and joined Edhi Centre and trained as a rescuer, which means I am on first response for emergencies like the Baldia Town case, but along with that, I am also the person who oversees the bodies arriving at the morgue. Being that close to something so final, seeing families break down seeing their loved ones gone, has changed me forever. If I was sensitive before, I am warm now. I have become extremely soft hearted as I see people sometimes even take their anger out on me, with no one left to scream their injustices to. I feel compassion for all these people, who affected by harsh realities, are simply looking for someone who will show them some sympathy.
I get to be more human here than I have ever been before in my life. To me it doesn’t matter that the person walking through the door is a Muslim, Hindu Christian Sikh or whatever; to me they are a human being who needs something and that is the biggest equalizing force in the world. The work I do here keeps my soul light and after all that I have seen and been through, I truly believe that there is no better job satisfaction than feeling at peace with yourself at the end of the day.”
Maqsood’s Story
“When I was in class 8, I was part of Scouts at school. We were made to participate actively at medical camps where we would treat people suffering from heat strokes. I remember the sense of purpose I used to feel during those activities. Helping others made me feel content and I knew that this was something I wanted to do for the rest of my life.
When I grew up I decided to join the Pakistan Coast Guard. Before embarking on that career, for three years I worked at the Edhi center. Thirteen years of service later, I retired and returned to where I started – Edhi.
Today, I work as a medical assistant in the nursing staff. I see some stories on a daily basis that I am left baffled at the nature of human beings. Recently, I met a man who raised six healthy sons after his wife died unexpectedly. He raised them alone and when they grew up, and he was in need of their support, they deposited him here at Edhi. I don’t understand how six sons could not handle one ailing father in his old age. When I see situations like these, it gives me a deep sense of satisfaction to step up and be there for people, particularly like that father, who deserved more.
I always knew I wanted to return to Edhi after my retirement because the fact is this is one place where human beings that the world rejects are not only accepted but also welcomed. People, who have been ignored, hated, bullied or ostracized for merely being who they are, come here with the knowledge and comfort that this is one establishment that will blindly embrace them and offer them a chance at a respectable life. And for me, it continues to be an honor to serve and attend my fellow human beings.
They say that your childhood experiences shape you into the kind of adult you grow into.”Wajid’s Story
“I ran away after my first day of working at the Edhi Centre.
Having arrived here from Hyderabad after both my parents’ death, fresh after Intermediate, I was alone and clueless and at the center was told I had to work with patients with mental and addiction problems. I had agreed to it without much thought and was so overwhelmed that I bolted.
But Edhi Sahab didn’t give up. My manager at the time was sent after me and explained to me, clearly and gently, that working at the center was unlike working anywhere else. That if we worked diligently, with heart and commitment, we would notice ourselves getting detached from the worry of the world. I think they understood what I needed at that time in my life better than I did.
Working with mentally challenged and people who suffer from addiction and substance abuse is tough. I attend to these people with dignity, calm and poise, no matter how dangerous, violent or repulsive their story or the person is. Every tear we wipe away, every word we patiently listen to when no one else will is rewarded when we hear them say a prayer for us. And when they pray for us, they save us from everyday burdens- of sickness and trial and strife. They are so grateful to us for helping them making things right – and when prayers come so directly from the heart we are filled with a blessing that cannot be touched because it is of the purest kind.
You know how they say, that when you have no direction, the person who helps you becomes your direction. That is what Edhi Sahab is for me. You could say I was born here. Now twenty years later, I have come a long way. I have a wife and kids, a home of my own and this job that gives more than it takes.”
Shagufta’s Story
“Though I originally hail from Larkana, I have lived most of my life in Karachi with my husband and three kids. It was a regular life, with the typical expectations until many years ago, my husband fell sick and needed surgery. With him unable to provide, it meant I had to get out of my comfort zone and get a job.
I started a job in a corporate company and began to believe that money was everything. Slowly that became my primary focus. I was convinced that it was money that guaranteed your position in the eyes of the world and people would only admire you if you were rich. Eventually I had to leave that job, and since nothing else was on the horizon, my family tried to convince me to join an orphanage as a cook. I was very skeptical. The wages were almost half at what I had been earning at my previous job, and given the high esteem I gave money at that time, I felt it would be a waste. Nonetheless, something in me said to give the place a chance.
At the orphanage, I felt almost an instant sense of relief at the friendly, relaxed environment and demeanor of the people. I felt at as if I was home.
The children felt familiar, like my own and it was then that I knew that I had been selling myself short. If I had to work, it should be in a place like this.
And that is what eventually brought me to Edhi Homes.
To this day, I am amazed at the level of fulfillment that my job brings me. Hailing from the corporate background, I could not imagine that the post of a cook that is not an officer level nor a managerial post could demand the kind of gratitude and regard that it does. I see the respect in the eyes of my managers and I am filled with a sense of worth that makes me want to do better.
Recently my husband had a heart attack and in between hospital runs, I could not be there at the center to cook constantly. Everyone came together to help. They made sure food was cooked the days I was unavailable and even the managers were supportive and understanding enough to allow me the flexibility without making it difficult for me.
Though my years at the company meant my wages were better, when I look back I realize there was no mental peace, no satisfaction even for the overtime. Here I work harder, the hours are almost double and the wages half, but God helps me survive and thrive because I truly feel like I am doing something good. I really do believe that this is what will be a means for my absolution later on. I know I am needed and what I do makes a difference.”
Mohammad Shafiq’s Story
“They say our circumstances can change our fate, and that one’s kismet can depend solely on where one was at a particular moment of their life. I think this is particularly true for me.
I grew up in the 90’s. It was a time of change for Pakistan and I have to admit I was a typical teenage “loafer”. My friends and I used to roam around, useless and lazy, creating mischief. We were insensitive to other people’s pain, often laughing at those who were hurt. Everything was a joke to us. Living in what was a marginalized area, things got very bad politically; so bad in fact that I remember we used to step out and see dead bodies everywhere with black kites feeding on them. The situation was so insecure and tense that they would not let even Edhi Sahab and his rescue ambulances come inside our area. I still carry the trauma of what I have witnessed with me.
Seeing the unrest up close however, had one good effect. It changed me. My friends and I evolved from those purposeless teenagers into actual caring human beings. We helped push dead bodies on donkey carts because we realized there was no one else there to help. Seeing the sorrow and pain people were in was no longer a joke. Today, I can barely stand to see someone suffering, and I think those hard days were the reason the passion to join Edhi Sahab’s team developed in me. To be honest, I think Edhi Sahab saw something in me that even I didn’t. I joined as an Ambulance driver, and after 12 years, I was moved to manage the fleets.
I remember once I was on duty, driving some bodies to Jinnah Hospital. I was parked and waiting outside when a bomb exploded about two feet away from me. Everything around me, my ambulance included, was destroyed. Even my cap was blown into pieces off my head, but I escaped with a mere scratch on my arm. Can you believe it? After something like that, something so close and horrifying, how can you not be convinced that God has some purpose for you?
Thinking about that day still sends chills down my spine and yet it also serves as a daily reminder that my job here is to help, that someone’s life depends on me, and that is what God intended for me to do, so I should be grateful and not waste the opportunities I am given every single day to change things for those around me.”
Mohammad Waqas’s Story
“How can one stay sane and on track with so much around us that can pull us down and render us incapable of any thought, much less positive action? I always wondered that myself, until one day a motorbike accident in college changed that for me.
I still remember vividly, the shaking body of the student before the ambulances arrived. The rescuers swooped in like heroes, controlling the situation and handling him with such ease and precision that I was awestruck. It inspired me so much- this strength and resilience in them which allowed them to serve humanity in this way. My college Principal had in the past, often spoken to us about having a higher purpose, about serving humanity, and the incident that day cemented my belief that this was what I wanted to do in my life. After all, anyone can get a job and earn money, but to be able help people in need and also make money would be an ideal dual purpose in life.
I joined Edhi right after graduating nearly 7 years ago and now work as a senior clerk in the center’s emergencies department. It has been a truly learning experience for me from day one and I have seen more than my share of terrible stories in the years I have been on the job. Being in charge of emergencies, it comes with the job description. There was one incident in Turbat I will never forget, where I had to pick up bodies with my bare hands, while ignoring the blood and gore around me. I couldn’t eat food for three days after that.
A lot of my work involves going to troubled areas like Landhi and Korangi to help victims of gunshot wounds as well. One would think doing this kind of work, I would need therapy or slip into depression but I have come to understand that I am wired very differently from most people. While ordinary people may run away from these incidents, I have always had it in me to run towards them to help.
Perhaps it is filmy of me to say this, but there is an inexplicable sense of joy when you actually save someone’s life. I suppose it is the adrenaline high that pushes any other feeling of sadness or fear aside, turning what you feel into a complete sense of accomplishment. The gratitude and prayers we receive from the families of those who we rescue go a long way towards making this the kind of job you cannot walk away from.
One of the toughest things to learn has been to empathize without succumbing to the emotions that we feel in those difficult moments. If we get invested in each person we save or help or bury, we would be rendered useless. We need to stay practical and strong while handling things efficiently. So you can say the greatest lesson I have learnt yet is not only how to handle emergencies and tragedies but how to stay human and be able to console those afflicted in the midst all of it.”
Parvez’s Story
“Everyone has a job they can do well, because they have that capacity in them or the talent. But the people who work here, they see impartiality in the way things should be, and it becomes their mission to make things better for all.
Despite holding a diploma in automobile engineering, I never had any interest in the greasy field and the thought of getting under cars to fix them was both annoying and boring. What truly inspired me was my wife’s work as a staff nurse so I started moving in that direction.
Before Edhi I was involved in patient care at hospitals and private care for the elderly at their homes. Now I have been on the rescue team as a “Madadgar” for over ten years. The most important part of my job is to get to the scene of the incident as fast as possible. I have to stay confident and move fast, without losing focus or letting anything distract me. Of course, how it all plays out is never in anyone’s control but we stay determined to get him alive to the medics as soon as possible.
What we do here at Edhi Foundation can only be done by individuals who have sympathy in their heart for all other people, regardless of their status. No ordinary person will be willing to stop at a roadside and pick up a person who has just been hit by a car. We even help those whose own family has run away, scared and unsure after an accident. I have thought about it often, but I don’t think this feeling and drive to help is something that can be learnt- you are born with it and those are the special people who end up at Edhi Foundation, changing lives.
One of the most important things I have realized in my decade of this work is that we are all equal. Here we see well off, educated people suffer from so many of the same things that a poor man is often burdened with. Accidents, mental illnesses and diseases do not look at social strata before striking. They can happen to anyone at any time.
I used to think income was everything , that the more you had the better things were, but now, my main focus and passion has become human rights- the need for everyone to be treated the same. It has been a lifelong dream of mine to open an old age home and all that I see at Edhi motivates me to keep working towards achieving that goal.”
Rizwana’s Story
“After you finish your Matriculation, you feel the world is yours. You feel that you can do anything anywhere, as long as you have the drive. But I knew I wanted to serve humanity. So at the age of 17, I joined Edhi Sahab.
Looking back, I realize that when I started I wanted to make a difference but did not have the kind of passion that I have today, almost 18 years later. It seeps into you slowly, this change and you stop caring by and large about the more worldly things that interest your peers, like fashion and makeup in my case; your mission becomes bigger.
Having worked at the Edhi center for 18 years, I now handle all the accounts of the donations that come in. Handling money and donations is not easy. One has to be extremely diligent and completely honest.
Given the levels of poverty around us, a person who is suffering financially may get tempted, but our work here is for others. Not everyone can do this job.
I have been lucky enough to work closely with both Edhi Sahab and Bilquis Edhi during my time here. Edhi Sahab used to walk long distances across cities on his donation collections across Karachi, Lahore and Islamabad. I was so young at the time and his work had a deep impact on me. He would sit in the heat, talking to anyone who wanted to talk to him. I truly felt like I was part of something great. He would tell me in his gentle voice, that even if the slightest effort of mine could go towards making someone else’s day better, then I should not think twice about doing so.
I remember particularly this one trip to America I accompanied Edhi Sahab. Despite having money to spend over there, Edhi Sahab would go to sleep at 5pm in the evening. He would wake up at 3 am and I would give him breakfast. Bilquis Edhi used to ask me why I woke up to give him breakfast. And my reply was, that if helping mankind was Edhi Sahab’s mission then helping Edhi Sahab was mine. All he did was make calls the whole day, for donations. I recall telling him that we were in New York and there was much to see so we should go out and enjoy ourselves. He would always quietly refuse and say his was on a mission for humanity and he would not stray from it. All he was interested in was helping mankind and that was the biggest lesson he left behind for all those who had the honour to work close to him.”
Gohar’s Story
“One of the most unusual things about life is that though you can hate how you end up somewhere, you can love where you end up.
After my husband’s death 8 years ago, I found myself in a life I was not prepared for. My husband had always taken care of my six children and us and we were now suddenly at a point where ultimately, I would be their only parent. I felt dejected and depressed, because children should have both parents to raise them and now mine would have no father.
I don’t know how I ended up at Edhi. Perhaps it was a calling. We all have this one point in our lives where, if we listen to our inner voice, we find ourselves at the right place.
Before I joined Edhi a year ago, I was a polio vaccination supervisor and did a lot of fieldwork. My faith in the human race had started dwindling quite a bit, as more and more situations showed me that people were generally self-absorbed and that we mostly lived in the world where people don’t consider or care about each other’s feelings. Even families don’t feel the need to connect or watch out for each other the way they used to anymore. I could feel that I was falling into a deep depression and finding no respite from these suffocating thoughts.
But my down ward spiral could not possibly continue once I stepped this environment and met the selfless and warm-hearted people who work here. I don’t know how but somehow, Edhi Sahab with his warm ways and dedicated work has created this amazing organization that not only provides hope for so many lost people but also provides an anchor for those working in it. I often sit and marvel at how he did it. He took one step, of caring for others and it has had a domino effect, changing hundreds and thousands of lives here in Pakistan. Here, he’s given lost and unwanted human beings not just a roof over their heads but a place to truly call home. He has managed to create a haven where anyone who has felt alone can walk in and belong.
Though I ended up here because of unfortunate circumstances, I truly cannot say that I do not wish I were here. These children at this orphanage feel like they are my own and I am putting my heart and soul into trying to raise them just as I raised mine. It is important to me that they turn out to be good HUMANS above anything else. I want them to learn how to deal with the realities of the world outside with compassion and warmth and not feel the kind of cynicism and disconnect that I had started feeling. I want people to look at them and admire them for how well they have been raised to handle what comes their way because only then do I feel I will have done them justice.”
As a woman, I am trying to find something positive to say about you. Your snow capped mountains and the gorgeous foliage were spectacular but it seems superficial to point this out. Perhaps I cannot make a fair assessment, having known you only for 1 week but I do think about all the women I observed closely in the maternity ward for days. I heard about their lives from the midwives and it scared me.
The lives of women really scared me.
I heard women have little agency over their lives because they belong to very conservative communities. I observed that they can’t travel even in emergencies to the hospital without a male chaperone. Tell me, why is it better for a female to die of complications at home rather than be saved at a hospital if the men of the house are at work?
I asked several women recovering in the wards to describe everyday life and picture they painted was bleak; they bear children, eat leftovers after serving their family and in-laws dinner, they cook, clean and keep having children till they can’t anymore. A large number of women put up with domestic abuse, marital and non-marital rape, multiple miscarriages and many other traumas due to poor healthcare. None of the 50+ women I came across were literate or had ever attended school. This is their life- there is no choice about it.
Timergara, are your women oppressed? Or is that question judgmental? Do they know they have equal rights to education? To have a say at home? A right to their own bodies and every other privilege men enjoy? The female hospital staff who moved from Pindi and Mardan say they miss their freedom. What is the idea of freedom for your women, Timergara? It has been hard to process the stories the female mental health practitioners told me. I learnt that most of the men work abroad as laborers. The wives they leave behind are often raped by their husband’s brothers. How can men be so cruel to their brother’s wives?
In his Ted Talk, Morgan Spurlock says that there are always 3 sides to a story; yours, mine and a third side that he calls the ‘real story’. So, I know there must be more to you, Timergara, there has to be. But, from my side of the story, you scared me.
It was the year 2009 and young, carefree, Ikramullah, was playing football with his friends in Munda, Lower Dir, when he saw large trucks coming down the road. A leader amongst his friends and curious by nature, he walked up to where the trucks parked to find out what was going on.
“A man named Shahid introduced himself to me and said he was from Islamabad. I did not know what MSF was so he explained that they have arrived to provide relief goods to the internally displaced people in our area.”
A budding humanitarian himself, Ikramullah had been volunteering with a local organization ever since the conflict had displaced hundreds of people in his district.
“They (MSF people) did not have any place to stay and asked for my help so I introduced them to some people I knew and arranged accommodation. After I did that, Shahid asked me to join the MSF team and distribute goods. I said I would be happy to volunteer my time and did not want any money but he insisted on paying me – he said that is not how MSF did things. This was strange and new for me but I appreciated it and was given the role of supervising the distributions.”
It was not as simple as it seemed to Ikramullah at the time when he agreed to this role. Over the next few days, he learnt how MSF did things – the protocols and rules that needed to be followed.
“ I learnt they (MSF) had their own way of working and they assured us that everyone who is in need will get the relief goods once they have assessed the situation. I had never seen this kind of approach before but I really appreciated it.
Ikramullah, Head Watchman at MSF in Timergara, KPK, Pakistan
Ikramullah observed how MSF carried out the assessment of which IDP families were needy and how the employees managed to win the local jirga’s trust – without which no one is allowed to work in the community. Quite used to seeing organizations come and go after a few days, he assumed that MSF would soon be on their way and hosted a lunch for them at his house to thank them for their work in his hometown.
“It was at the lunch that they told me they were going to stay for a few months.”
And so, his journey with MSF continued. The same year, Ikramullah went with MSF to visit a large IDP camp in Samarbagh, Lower Dir, where families did not have food, shelter or toilets. He helped gather over 160 laborers for MSF and started construction of the bathrooms the very next day. MSF also opened outpatient services (OPD) for the IDPs along with providing drinking water and shelter for over 600 families.
“To me, the most commendable part was that they MSF always followed their own rules and regulations instead of being influenced by anyone. After finishing emergency work in this camp, we took over another camp in the same Tehsil which was situated 6 kms away from Timergara in the mountains where I handled the emergency chlorination of water.”
Jalozai Camp for Internally Displaced Persons (Nowshera, KPK, Pakistan) April 2016
“I remember, just when things had started to get better in Bajaur and Medan, MSF had taken over a camp in Mundir where over 1800 families had been living inside shops in the market. The local authorities had issues with the location of the camp and asked us to remove it within 24 hours.. Within a month we arranged for a new camp to be functional in another area of Lower Dir called ‘Walai’. We got as much labour and help as we could because children and families couldn’t bear the cold weather conditions for too long.”
In 2009, 52 people, including Ikramullah, were stationed at the DHQ, Timergara, including 3 people from the department of health. It was then that he was officially offered a contract which he accepted and was given the responsibility of supervising 30 watchmen and laborers at the hospital. At the time MSF only managed a part of the Emergency Department but eventually took it over entirely.
District Headquarter Hospital, Timergara, KPK, Pakistan
“Once we found out more about MSF and their mission, we spread the word about it in our local community. I have never seen an organization that believes in working this hard for the betterment of people. I am not praising MSF because I am an employee- I have nothing to gain from false praises. I say this because I have seen it from the inside for over 12 years and can vouch for the purity of their intentions.”
According to Ikramullah, 99% of the people in Timergara District as well as neighboring districts are satisfied and happy with treatment provided by MSF. He claims this level of satisfaction is achieved because MSF is works on their own terms and very fairly.
“I learnt many things at MSF, how to be fair is one of them and I will carry these learnings in whatever I do for the rest of my life.”
MSF’s Head Watchman, Ikramullah, with his team outside the MCH in Timergara, KPK, Pakistan
“Médecins Sans Frontières has provided an emergency medical assistance programme in Timergara District Headquarter Hospital since October 2010. This assistance includes support to the Maternal and Child Health (MCH) department,, in the form of human resources, provision of medical and logistical supplies, as well as rehabilitation of the emergency operating theatre, recovery room and acute post-operative wards and full support to sterilization, hygiene and waste management. The hospital is meant to cater to the inhabitants of Lower Dir (where Timergara is located), but patients also come from neighboring districts, with the majority coming from Lower Dir, followed by Upper Dir and others within KPK as well as the Federally Administered Tribal Areas (FATA). All services are provided free of charge.
Somewhere in a remote village of Bajaur district (a former Federally Administered Tribal Area in Pakistan that borders Afghanistan) 27-year-old, Asiya, is waiting to give birth in her home on a cold December night.
She has a cup of hot tea and starts feeling the contractions. Since this is her sixth pregnancy, she is gripped with anxiety. With only one child alive, she lost all others to early neonatal deaths and still births. She hopes this one will make it so that he six-year-old son will finally have a sibling.
Something goes horribly wrong when the baby starts to come out but instead of the head or the feet, out comes a small hand! Panicked and frightened, her husband (a religious leader at a local mosque) rushed Asiya to the nearest medical center which was a two hour drive away.
When they reached the clinic, the doctor recognized that the baby was in a transverse position with a prolapsed hand and that this was beyond the clinic’s capabilities to handle. The couple was referred to MSF’s mother and child health unit in Timergara.
Timergara, KPK, Pakistan
Asiya recalls the six hour painful journey to Timergara with her baby’s arm sticking out of her;
“I was 100 percent convinced my baby is dead that I am going to die also! I left everything up to God because I knew it was out of my control! I was so afraid that they were going to cut me up!”
Dr. Shumaila, the gynecologist who was on duty that night, said that she took a quick but calculated decision when Asiya arrived at the MCH at 7:00 am; “When I saw the patient, I did a quick assessment of the situation. The nurses had already started preparing for a C-section but I felt confident that I could deliver the baby normally. I took the patient’s consent and went in for an internal podalic version; a procedure in which I put my hand inside the vagina, grab the legs – rotate and then pull the baby out in a breech position. Thank God it went smoothly. The baby cried loudly so all was well!”
Since she joined MSF in Timergara, this is the third time Dr. Shumaila has delivered a baby in a transverse position with a prolapsed limb.
Gynecologist, Dr. Shumaila, with a new born baby at the MCH managed by MSF at the DHQ Hospital in Timergara, KPK, Pakistan on 10th December 2020.
“This kind of situation usually arises when the women have not gone for proper pre-natal checkups to a hospital. Usually they go to a ‘dai’ (untrained midwife) at the time of delivery and when the ‘dai’ tries to induce a baby who is in a transverse position, the limb comes out first. Luckily, Asiya’s husband did not overthink and came to us directly or else we could have lost the baby.”
According to Dr. Shumaila, if they had waited for a c-section, by the time Asiya would be given anesthesia, the chances are the baby would have lost her heartbeat.
“Asiya was very cooperative. I could tell she had all but given up on the chances of her baby surviving so when I told her the baby was okay and that she needed to trust me I could see her get hopeful again.”
A few hours after delivering a healthy baby girl, Asiya could not be happier.
“I was certain I was going to die but the doctor was amazing and she delivered my baby normally! I can’t believe I didn’t need to have an operation. I’m the happiest woman in the world right now!”
MSF Gynecologist, Dr. Shumaila, delivered a baby that arrived with a prolapsed hand after a 7 hour car journey at the DHQ Hospital in Timergara, KPK, Pakistan on 10th December 2020.
After difficult births, all new born babies are sent to the DHQ Hospital’s New Born Unit for a full assessment by the pediatric doctors and specialists. Dr. Waqar Alam, the District Orthopedic Surgeon from MOH, checked Asiya’s baby and ordered an ultra sound of the arm.
“From what I can tell, there is clear trauma to the hand but there is no dislocation or fracture. We will know more after an ultra sound but are hopeful the baby will make a full recovery.”
(Patient’s name changed upon her request)
A baby is soothed by her aunt shortly after being born. MSF Gynecologist, Dr. Shumaila, delivered this baby girl who arrived in a transverse position with a prolapsed arm after a 7 hour car journey at the DHQ Hospital in Timergara, KPK, Pakistan on 10th December 2020.
“Médecins Sans Frontières has provided an emergency medical assistance programme in Timergara District Headquarter Hospital since October 2010. This assistance includes support to the Maternal and Child Health (MCH) department, in the form of human resources, provision of medical and logistical supplies, as well as rehabilitation of the emergency operating theatre, recovery room and acute post-operative wards and full support to sterilization, hygiene and waste management. The hospital is meant to cater to the inhabitants of Lower Dir (where Timurgara is located), but patients also come from neighbouring districts, with the majority coming from Lower Dir, followed by Upper Dir and others within KPK as well as the Federally Administered Tribal Areas (FATA). All services are provided free of charge.
“Antenatal care in Pakistan is far from satisfactory. The reason being that majority of the population live in rural areas, with a high illiteracy rate, restricted health care facilities with an underlying synergistic background of anemia, malnutrition, infection and unregulated fertility. Consequently, a large majority of patients reach hospital too late with features of obstructed labour with grave consequences. Poor patient compliance to the advice given due to lack of understanding and education with a tendency to rely more on advice given by traditional birth attendants. Good intrapartum care can easily diagnose the condition. Prevalence of obstructed labour, an obstetrical disaster, is influenced by availability, quality and acceptance of maternity services in a community. The long term solution lies in prophylaxis i.e., provision of adequate antepartum and intrapartum care which could avert the preventable nature of obstructed labour.”
(Photos and story by Khaula Jamil for MSF Pakistan)
After two years of marriage, 26-year-old Zaiba, finally conceived a baby. Hailing from a small remote village in Bajaur District, Pakistan, she grew up in abject poverty with her three brothers and four sisters. Life was never easy for Zaiba. At home, she had two brothers with mental illnesses and was eventually married off to an unemployed sick young man from a neighboring village. Uneducated herself, Zaiba is dependent on her father-in-law to provide for her and her husband while she stays at home and helps her mother-in-law with household chores.
26 year old, Zaiba, a mishandled patient from Bajaur District is being treated at the MCH managed by MSF at the DHQ Hospital in Timergara, KP, Pakistan on 8th December 2020
On the night of 10th December, the end of her pregnancy term, Zaiba started feeling a nagging pain in her back. She sought medical help from a private clinic for which she had to travel four hours by road to the nearest city.
“The doctor gave me 3 injections and two tablets and told me I would be fine in a few hours. I did not get better! I went to a Lady Health Visitor at another place and she gave me two drips and told me to keep walking in order to deliver the baby.”
26 year old, Zaiba, a mishandled patient from Bajaur District is being treated at the MCH managed by MSF at the DHQ Hospital in Timergara, KP, Pakistan on 8th December 2020
It was several hours before the traditional birth attendant (TBA) told her she needs to go to the MSF facility in Timergara (a six hour drive away from the clinic) because her situation was beyond their abilities to care for.
What Zaiba did not know was that she had been terribly mishandled by both the TBA and the LHV. After gathering the patient’s history, Esther, MSF’s midwife manager at the maternity unit in Timergara, shared her assessment of what happened;
“Zaiba received a very high dose of Oxytocin and Misoprostol tablets which induced premature labor. When she arrived at MSF, the baby’s heart beat was faint and the patient had developed complications.”
MSF Midwife Assistant manager, Shabana, checks the pulse of a a mishandled patient who delivered a baby at the MCH managed by MSF at the DHQ Hospital in Timergara, KP, Pakistan on 9th December 2020
Oxytocin is a medication used to begin or improve contractions during labour. If used incorrectly can lead to the uterus rupturing and neonatal death. In Khyber Pakhtunkhwa, exposure to unregulated treatment with labour-inducing medication is common. Despite carrying high risk for mother and child, the traditional birth clinics tend to use this drug without much caution.
“The baby was in severe distress and the patient was bleeding. Luckily, we delivered the baby and he is alive (for now) but his oxygen levels are low and he needs to be observed closely over the next 48 hours,” continued Esther.
Zaiba’s baby will be in the neonatal care till he stabilizes. His birth weight was 4kg – too big for a normal delivery for a woman as petite as Zaiba, therefore delivered through an emergency c-section. She will also be receiving counselling in regards to birth control and spacing since she needs to allow her body to heal from this trauma.
A new born baby, who was delivered after his mother, Zaiba, arrived at the hospital due to a mishandled pregnancy, fights for his life in the NBU facility at the DHQ Hospital in Timergara, KP, Pakistan on 8th December 2020.
Birth trauma aside, Zaiba’s abdomen is full of blood post-delivery. She will remain admitted at MSF in the post-op ward for several days till her urine is clear. A very worried mother-in-law is by her side with not just her daughter-in-law’s condition to take care but also the finances it cost them to get her here.
“My husband is the only earning member of the family and he works in another city. We paid the LHV Rs 1,300/- and it cost us Rs.5000/- ($40/-) just to get here after driving almost 7 hours. I don’t know how we will pay this amount but my husband will have to arrange it somehow,” she says.
She regrets not bringing Zaiba to MSF directly when she did not get better after the first three injections she received. However, thinking they could save the expense of travel, they decided to keep on waiting – till the situation got out of hand.
After her near death experience, Zaiba is finally gaining her strength back – enough to feel angry about what she was put through by the Lady Health Visitor and TBA before she came to MSF; “If I could, I would go back and strangle them for what they did to me! They kept saying push and walk till I collapsed due to exhaustion.”
MSF Midwife Asstistant manager, Shabana, helps a mishandled patient walk with the help of a nurse and the patient’s attendant. 26 year old, Zaiba, delivered a baby at the MCH managed by MSF at the DHQ Hospital in Timergara, KP, Pakistan.
Over the next two days, Zaiba started walking and eating. With her stitches healing slowly, her mother-in-law and the MSF midwives help her with her movements. What she has not been told yet, however, is that after two days of fighting for his life, her baby did not survive.
“Médecins Sans Frontières has provided an emergency medical assistance programme in Timergara District Headquarter Hospital since October 2010. This assistance includes support to the Maternal and Child Health (MCH) department,, in the form of human resources, provision of medical and logistical supplies, as well as rehabilitation of the emergency operating theatre, recovery room and acute post-operative wards and full support to sterilization, hygiene and waste management. The hospital is meant to cater to the inhabitants of Lower Dir (where Timergara is located), but patients also come from neighboring districts, with the majority coming from Lower Dir, followed by Upper Dir and others within KPK as well as the Federally Administered Tribal Areas (FATA). All services are provided free of charge.
Use of labour-inducing medication by insufficiently trained cadres of healthcare workers is prevalent in a vulnerable population of Pakistan. The stakes are high, with unregulated usage of such medication resulting in severe consequences for mother and child. Tighter regulatory control measures for the use of labour-inducing medication, as well as better training and awareness among healthcare workers and the community are critical to improve this situation.”
A week back a friend posted a picture smiling next to a lush green park with a beautiful Victorian building at the back. I thought he was in England. When I looked closer, it was Empress Market. I couldn’t believe it – I had to see this with my own eyes.
Empress Market (June, 2020)
I finally made it there a few days back. The guard uncle told us that the meat area is being turned into a library/museum.
June, 2020
June, 2020
This doesn’t sound right at all. Empress Market is chaos, texture, sound, smell, taste, touch, nostalgia all rolled into one magnificent experience.
Anyone who has grown up in or even visited Karachi has some kind of memory of Empress Market.
Empress Market street view (2014)
A go-to veggie and spice shopping stop for many bulk buyers, an essential weekend trip for the loyal local and a “must-take-our-foriegner-friend-to-show-authentic-Pakistani-culture” pit-stop for others. Aside from photographing and gathering stories for Humans of Karachi numerous times, I got the love of my life, my pet cockatiel, Pavo, from there.
The bird market was one of the four markets that was demolished
The meat market section is apparently going to become a library/ museum
This gorgeous one hundred and thirty one year old place with history so rich that we have barely scratched the surface discovering is going to be gentrified. This is not necessarily a bad thing if it’s done right. If certain considerations are kept in mind and if the people who inhabit the neighborhood benefit in some way. Restoring the market to it’s “former glory”, as what has been advertised by the anti-encroachment drive, is a loaded and complex concept. Which past glory is being referred to here? Before or after Zia’s Regime (1977)?
Poultry section of Empress Market
Back in the day, Saddar was a booming artistic hub catering to diverse communities. Cinemas, bars, clubs, cafes and music schools made this city centre a multi cultural hub. But then the 80’s happened. Over the last 30-40 years, nearly 1700 shops illegally popped up outside the market. The organic growth thrived (through extortion), unchecked by authorities, till 2018 when the Supreme Court ordered all of them be removed immediately.
These are all the shops the anti-encroachment drive demolished in 2018
This new culture that Pakistani’s had come to accept and enjoy as part of Karachi was under threat. Within days, four major markets that had over the years blended in with the original master plan were demolished amongst protests from shopkeepers who had been paying rent to KMC and had deals in place. They say 200,000 jobs were affected. New deals were offered and the job was done. The razed set ups found new streets close by to occupy.
Poultry section of Empress Market, 2015
A man with his prized chicken at Empress Market, 2015
Saddar suffered amidst the heavy machinery and demolition. The area lay devastated for a while. I avoided going there because I could. Others were not that lucky- friends who lived there were distraught. Articles were written, conversations were had as plans were being drawn up by the authorities on the future of the reclaimed land. I am still not certain what the future holds for this place – we have heard many things. The only hope is that the government involves architects and heritage consultants to move forward with any plans because what this city needs to preserve and restore is Saddar’s character as a multi-class and multi-ethnic city centre. With Empress Market being at the heart of this hood, it is crucial that its future not be taken lightly.
Tupperware section at Empress Market, 2016
So what can we do to help? People like you and me?
We can be aware. Be concerned. Talk. Read up and discuss the matter with family, friends and colleagues. Ask questions. Start a dialogue. Make art. This is our city, it is our job, our moral burden to care about what happens in our space because if we don’t take ownership now, we won’t have a right to complain later.
I have been going on freelance assignments with an organization called Better Cotton Initiative (BCI) since 2017. We do at least one if not two stories a year about cotton farmers in Pakistan and how BCI helps train them to produce better crop while promoting decent farming practices to help the farmers in their personal lives. My job involves not just photographing the story, but also conducting a lot of the interviews.
Here are links to some of the stories I have worked on for BCI.
In November, 2019, I went on assignment for International Finance Corporation (IFC) to Jhimpir, Sindh, to document community life in and around wind power plants. The idea was to gather stories to understand the impact of how these energy producing corporations setting up their plants in this rural setting had impacted the local community.
Somewhere in a village called Mehrab Solangi in Hyderabad, Pakistan, lives 42 year old Sara Solangi with her husband and two children.
As a community group member and a beneficiary of a Women’s Leadership training program, Sara is a force to be reckoned with. She has been campaigning for fair and equal access to water for her village for the last three years and has lead the way for many women to raise their voices to be heard by the feudal lords and local ministries.
What is unique about Sara’s situation is the unwavering support from her husband, who unlike most men in their village, openly dotes on his wife. He encourages her to speak up at meetings and helps her equally with all household chores.
Sara knows that she is incredibly lucky to have such a partner in her life;
“During Ramazan, when I wanted to go into Ehtikaf (solitary worship), he did not hesitate to take over running the household for the few weeks that I was away. Sometimes the people in our village make fun of him but I personally think they are all jealous!”
In order to give back to the community, Sara and her husband let the local school use a room in their house to conduct classes out of. They say that it brings them happiness to be of use to the village and the children. Sara admits that she never studied beyond primary level and enjoys sitting in the classes occasionally.
Together, the couple have two children who were born after nearly eleven years of marriage.
“For many years, I thought I would never be able to have children. My husband was so loving and supportive even during that time and then finally we were blessed with a son and shortly after our daughter was born.”
KHAULA ON THE MOVE 