I am torn. I am drowning in an ocean of emotions and thoughts. At times my mind and my heart are in conflict with each other but at times they are in sync.

I do not remember the moment when I left Karachi for Canada. I was too young to remember my thoughts and emotions at that time. Even as I got older in Canada, I felt as if my life in Karachi was from another lifetime…a previous lifetime…or maybe it was a fairytale. Sure certain tastes and smells would jog my memory about Karachi but it was never the whole picture. Bits and pieces of memories would sweep me away. It was as if I was imagining everything…nothing was real yet it was only because I was told it was so by my parents. I had always imagined what my life was like while in Karachi…my birth place.

Now that I have lived in Pakistan for almost 8 months, I cannot bring myself to leave this place. Of course I am excited to see my family and friends back in Canada but my heart will not let me leave this place. I am all too aware of my emotions and thoughts now. This is not a fairytale anymore. This is my life. I now feel the bond and connection I have with my country and with my countrymen and women. I feel their pain and their joy. I laugh and cry with them. I pray and work with them. Yes I am my own person, unique in my thoughts, emotions, principles, morals and ethics but I share a great deal with my people. I am cut from the same cloth….

I Love, with a capital L, the people and the culture. I enjoy the multiplicity of ethnicities. I enjoy the presence of different languages, religions (Muslims, Hindus, Christians) and practices--the ground work for pluralism. Too bad some individuals are too concerned with speculating what divides them rather than what unites them. Sure I do not agree with the government and some of the nuances I have encountered, but my goal should be to work with the system. Pakistanis and Pakistan as a country has so much to offer to the world. This land is full of resources. Its people are wise with extraordinary talents. I am not saying this out of bias but from sheer conviction. If only the world would realize this. If only Pakistanis themselves could realize this…

Often in Canada I would proudly proclaim that I am a ‘Pakistani.’ No wait...a Pakistani Canadian. But who was I kidding? I did not know anything about Pakistan or what a ‘Pakistani’ actually means. I was already struggling to find my identity. I was struggling to fit in with a new crowd and a new culture in a new country. I found my self becoming too engrossed into the ‘Canadian culture” that I had forgotten about my roots. It took a while for me to assimilate with the rest of my Canadian brothers and sisters while being true to my own principles, morals and ethics. With all tests come great lessons. The struggle continues to this day.

And now I wonder, what does it mean to be a Canadian? What does it mean to be a Pakistani? Who defines this and by what criteria? Is it based on how one acts? Or how one thinks or feels? Just because I hold a Canadian Citizen Passport or a Pakistani National Identity Card does that define who I am? Are we merely labeling ourselves for our own convenience? Are we not all Global Citizens as we have a responsibility to all of mankind?

A friend of mine made a comment recently, which has left me deep in my thoughts. “Identity is not a single thing. It has dimensions….good dimensions are those which care for human beings, the bad are those which undermine human dignity.” So true are his words. With that in mind, my last few weeks will be spent reflecting on those dimensions. Yes I am a Global Citizen, which includes being a Canadian Pakistani. This is not based on which cards I hold, but on the dimensions I decide to adopt and act upon. Action towards those who are less fortunate lead better lives while respecting their autonomy and dignity. This I know will require time and patience…

I leave Pakistan knowing what I need to do next. What I need to do for this country. It took me more than 20 years to return to my birth place. I only pray that it does not take me more than 20 years this time around. The memories of Pakistan, in all its shape, size and form, will remain etched in my Heart, Mind and Soul. Until next time….

As today is my last day in Pakistan, I am recalling the wonderful moments I have experienced here as well as the lessons I have learned. This has truly been a life changing experience, and this is no cliche. For years and years my dream was to come back to Pakistan and work in AKU. I can proudly say that my dream has come true. I will let you in on a secret. While thinking about pursuing nursing as a career, I had talked to Shams Kassam Lakha, President of AKU at that time, about the possibility of me pursuing nursing at AKU. He humbly advised me to finish my program in Canada and then come back to Pakistan to work. Well, I didn't really work as a nurse while here but I was definitely blessed with a wonderful opportunity.

I apologize if this is long but the following is a recap of my experiences while in Karachi. These have been moments of joy for me and each of them has been a blessing. I wish to share these with you, my dear friends...



- Re-connected with my birth place and my childhood.
- Visited the our home in karimabad that we left Canada from. I then realized the hardships my
mom and father had gone through to raise and take care of us. My parents left Pakistan with
the belief that us children will receive a better a education. To be back in Pakistan
after acquiring my BScN was truly a humbling moment and one filled with many thanks.
- Experienced genuine Love and Spiritual Ecstasy. My Soul lifted on several occasions and
strengthened my bond with the Divine.
- Made amazing and lifelong friends. People who I had met for the first time but felt as if I had
known them forever…Maybe in a different lifetime…
- Experienced a life outside my own narrow world and loved every single moment of it
- Experienced first-hand how others live and struggle in life and how they do so with joy and
laughter.
- Learned a multitude of life’s lessons through people I had never met. Compassion, gratitude,
and sympathy amongst many others.
- Witnessed both the sadness and joy in the eyes of many
- Experienced poverty and destitution, hunger, environmental degradation, lack of political will,
lack of enterprise, illiteracy, frustration and anger, terrorism, and violence.
- Witnessed strangers lending a helping hand regardless of age, race, gender, class, ethnicity, and
religion. People are wrong....civil society does exist in Pakistan, but to a different degree.
- Experienced the power of language but also the power of human connection without the use of
any words

- Achieved my goal of having more questions when leaving this country
- I see my goal, my focus, my path and my destination. I now know what I need to do
- Through my many field visits, I saw how people live together, eat together, and pray together
- Wore many hats as an intern: learner, educator, event planner, administrator, leader, clinician,
and many more. All these roles came with lessons and challenges but all very rewarding!
- Learned a great deal about health and health care systems, primary health care, government
and non-government health care structures, maternal and child health, and the list can go on
and on…
- Had the wonderful opportunity to be taught by intellectuals and visionaries. Such amazing
people here! So much brain power!
- Given the opportunity to visit various NGOs: AKU itself, Urban Health Programme and
HANDS
- Had my dreams fulfilled of working for AKU and AKHSP (trip to Northern Areas and
volunteering at Noorabad Health Center).

- Spending time with family. Meeting those family members whom I had never met before or
was too young to remember
- Blew up my kitchen the first day of moving into the women’s residence.
- Experienced intense security and safety issues, with a case in particular.
- Rode on a camel twice at sea view. However, while mounting the camel the second time I
ripped my pants… Yes the noise of the tear was loud. Yes it was a pretty bad tear. Yes it was
extremely difficult to mount off without giving every one a show.
- Re-discovered my love for climbing trees. In love with on particular tree outside my residence.
I love the way it makes me feel – liberating.
- Realized I had Michael Jackson’s blood running through my veins – My moonwalks and other
‘dances’ in public spaces.
- Had my first and only Hen/bachelorette party in Karachi thrown by my wonderful girlfriends.
This involved walking around the city and malls with a veil and flowers over my head, asking
random people for random marriage advice and singing marriage songs to random people.
- Rode my first quad bike at Go-Aish. Accelerated without knowing how to steer or brake,
crashed into the wall, got thrown off the bike, and landed on my head on the cement. Alive to
talk and joke about it!
- Driving for two hours to find Dream World. Once around the vicinity, taking one more hour to
find it. Wondering if this place is actually a dream, like ‘never never land.’ Once there, enjoyed
the water slides, archery, horse back riding and rodeo.
- Faced my fear of swimming by teaching myself how to swim. However, because I still do not
know how to swim properly and keep my eyes closed, I crashed into the wall and hit my head
pretty hard. I had the biggest bump on my head and two days of headaches.
- Faced my fear of Chipkalis (lizards). I am not completely over this fear but I feel I have made
pretty good progress.
- Had ‘stomach issues’ for four months, including an episode of traveler’s diarrhea (sorry for the
details). I refused to take antibiotics until I was cornered. Also had three chest infections. I
blame the pollution!
- Travelled to the Northern Areas of Pakistan: learned about the health care system, enjoyed
the company of wonderful people and re-connected with nature and culture.
- Attended my first outside rock concert (‘Call’) and the ‘after party’ after the party!
- Attended my first outdoor soccer game-Manchester United and Barcelona Finals
- Attended my first cricket final (even though if it was inside in an auditorium). Experienced the
joy of Pakistan’s win with my fellow brothers and sisters. Falling in love with Afridi. The only
girls dancing on the stage after the win, which created a fight.
- Developed a love for bargaining at various bazaars and markets. Enjoyed joking around with
the merchants in order for them to cut me a deal. My favorite tag line: “Mein apki favorite
customer hoon” which means “I am your favorite customer.” Shopping was always great fun
with a multitude of colors, fabrics, and designs. Pleasure to the eyes.
- Learned how to buy fabrics and get outfits made at tailors. This was not an easy task at first-in
fact it was very tedious and time-consuming. However, I think I have gotten the hang of this!
- Developed a love for riding in rickshaws and sticking my head out to see what the world has to
offer.
- Re-connected with my fellow HDPians on route to Pakistan and while in Karachi and Gilgit.
- Re-experienced the joys of my childhood favorites: Gola Ganda, Halwa puri, Kheer puri,
biryani, Nihari, Haleem, Guban, Kulfi on a stick, faluda and so much more!
- Discovered new local dishes like handi and Afghani pilau. Shawaras at Guru mandir, Thai food
at Bhan Thai, and Chinese at Peeking, My ultimate favorite restaurant: Chatterbox! Food,
food and more food!!!
- Experienced the joys of late nights with great friends and good food. Drinking chai and the
infamous ‘plain cake’ at AKU cafeteria. Sunday breakfast with the girls.
- Enjoyed street food, even though the after affects were not so pleasant. Ice off the street.
Sugar cane juice from sketchy vendors. Bun kabab that led to food poisoning. I heart street
food!
- Experienced monsoon season in Karachi. This resulted in spending the night at a friend’s house
as road conditions were too dangerous to go back to residence.
- Tolerated +40 degrees Celsius- of dry and arid heat. Sweating buckets and smelling of body
odor. The talcum powder, body sprays and multiple cold showers in a day became my best
friends.
- Enjoyed a variety of delicious and sweet fruits at every season. My favorites: falsa (similiar to
cranberries), mangos and Guava.
- Enjoyed some Jamat Khana hopping and visited many Ismaili colonies.
- Developed a crush on Dr. S and Dr. Z. Oh so wise and caring! Lets not forget good looking too,
especially Dr. S!
- Sunday Bazaar, Sadaar, High tea, cafeteria food, chilling at sea view, the memories go and on...

Shukar Shukar Shukar!!!

Last night was a historic for me. I celebrated Paksitan's independence day in Pakistan! I purposely delayed my flight back to Canada by a few days just so I can celebrate this day with my fellow brothers and sisters. What a night it was! After dinning at Lal Qila (a restaurant thats a Mughal-inspired castle) we headed to the streets. I had my Pakistan flag wrapped around me and celebrated like the rest of the Pakistanis. Celebrations were occuring in all parts of Karachi but the area we went to was surrounded by thousands and THOUSANDS of people! Never have i seen so many! However, it seemed to be more of an MQM (a political party) rally than anything else. There were more MQM flags than Pakistani flags. People were chanting and singing and really making the most of the day. Flags were everywhere-on motorcycles, cars, and bicycles. Little children were also proudly waving their flags. Men had their flags wrapped around their heads. Many were dancing on the streets while blarring loud Pakistani music. Merriment was in the air. With all my years in Canada, independence day celebrations in Pakistan has got to be the best I have ever experienced!

However, a question, actually many questions, were disturbing me. Even though we are celebrating Pakistan's independence, are we really independent? With all the outside influence, do we really have autonomy? Would the founder of Pakistan really be proud of the state Pakistan is right now? Is this what he had imagined Pakistan to be. I dont know...I feel that Qaed-e-Azam would not be happy right now if he were alive. Sure we have come along way, but we have even longer to go. So sure I am celebrating Pakistan's independence but my spirit is not there and it wont be there until we really earn our independence.....

Yesterday we made a field visit to Thatta located in interior Sindh province of Pakistan. As part of the Maternal and Newborn Health Registry in Thatta, the purpose of this visit was to visit households in various villages to conduct post-partum follow up assessments and monitoring adverse events. This also entails health education and health promotion.

No difference is made between urban and rural parts of Thatta as both are considered to be slums. Sure you can notice some differences with regards to health and socio-economic factors, but these differences are minimal. What I saw yesterday and what I see in almost every field visit since I have been here should seriously be considered a public health emergency. Disease-infested sewage water (the remains of recent torrential rains) almost anywhere you look. Piles of garbage scattered all along the streets. Swarms of flies and other disease-carrying vectors trying to get a piece of you. Poor literacy rates. Stray cats and dogs, also carrying God knows what, roaming freely around in search for some human blood and flesh. Below poverty line. Traditions and beliefs interfering with health and well-being. Complete lack of awareness. Ignorance. I can go on...I really can...

All this makes providing health care such a challenge! Villages are located so far away in isolated areas that health care workers have to travel afar just to conduct health assessments. Roads are poorly constructed, requiring health care workers to travel by foot for hours. Monsoon seasons make it impossible to travel, leaving villagers with health concerns stranded for days, even weeks. Government-run Basic Health Care units and Hospitals are so poorly equipped with inadequate human resources and supplies that they do more harm than good. From the 400 NGOs that are currently working in Thatta, only a few are actually serving people rather than themselves. This has been proven by poor health indicators which have not improved for years. To top it all off, it is difficult to provide health education to individuals who refuse to believe that one has some form of control over their own health and well-being. Sure God is Omnipotent and Ever-Powerful but human beings have also been given an intellect. That is why God has created human beings at a higher status than animals, because of our ability to use our intellect. So what is the purpose of this blessing when we leave our faith to jinn or some other supernatural power. This is definitely a complex matter with multiple factors involved. Families through generations and generations have accepted this way of thinking and passed it along to their children. We should not tell them that their way of thinking is wrong but work with them and use the "yes...but" approach.

I would like to end with an experience at one of the home visits. The mother has three surviving children and two that have passed away. The baby that recently passed away (5-7 days ago) was actually doing well right after birth but later that night, the baby passed away after experiencing seizures. It is believed that the child may have received a BCG immunization a few hours after birth, resulting in a fever right after. It is being speculated that the child may have experienced a febrile seizure. This child was in the womb for more than 9 months, in fact 10 months. The doctor had suggested a Cesarean section to the woman but she refused as she was deeply concerned about her remaining children and who would take care of them. Also, it is a known fact that surgery is much more expensive than a natural birth by a Dai (which is also not the safest in this part of the world). Therefore, the mother was induced into pregnancy via Oxytocin. One of the three surviving children of this woman was in severe health condition. I will never forget her face. I will never forget her eyes. Nor will I every forget her cries. Imagine a young girl with a severe skin infection from the time of her birth. Her skin has peeled away with ulcers throughout her body. Her fingernails and toenails are completely gone. She only has patches of hair on her head. More than half of her teeth are gone, exposing her raw gums. Ulcers are also located inside her mouth. It appears that she has not taken a shower in years and the clothes on her back have not been changed. Dirt has accumulated from head to toe. She has dirt caked on to her feet. She is surrounded by flees. They all are attracted to her and sticking to every inch of her body. They are entering her mouth, hovering around her eyes and on the sticky, brown 'Popsicle" she is sucking on. These flees are basically eating her up. She cries as she holds on to her stomach. We ask what is the matter. The mother says she has a "stomach ache" which is fairly common for her. We ask if she has seen the doctor but mother says she has no money. If she takes her to the doctor, then the rest of her children will suffer. The child cries...but there is something unusual in her cries. This is not merely a cry of pain..but a cry of despair. A cry begging us to "save her." This was the most heart-breaking experience. I wish I could just take her in my hands and cuddle her and tell her that everything will be ok....but her eyes say something else. She knows everything is not going to be ok...she herself has given up hope. How easy would it be to just take her to the hospital myself but her family wont let me. If we offer free health services and transportation to the family, the family will not take it for reasons unbeknownst to me. This has happened several times before. If this was the case in any other part of the world, I am sure that social services would have stepped in by now. But what right do we have to take this child away from her mother. I will not dare claim that this mother is neglecting her children as her hands too are tied. She is part of the vicious cycle where the poorest are neglected and the family members show love in the only way they know how. She has her family to feed and the rest of her extended family depend on her as well. She too is fighting an infection for days and for that she is not seeking health care as that too is expensive. This situation all too common here...

Oh how I wish I could do something! How horrible this feeling of knowing that I can do something but not being able to. However, I will not lose hope...I will not despair...

“There are those …who enter the world in such poverty that they are deprived of both the means and the motivation to improve their lot. Unless they can be touched with the spark which ignites the spirit of individual enterprise and determination, they will only sink back into renewed apathy, degradation and despair. It is for us, who are more fortunate, to provide that
spark.” - Aga Khan, India 1983

More than 2000 families migrate to Karachi daily. However, the ones who migrate are already so poor that it is difficult for them to find any permanent residence. They are unable to find jobs and neither can they find housing. So, what happens? They live on the streets without a roof over their heads. Nothing to call their own...

Now you ask, "Well, can't anybody help them?" Who is going to help them? Even though the government has tons of money, they are not allocating resources appropriately to the people who actually need them. They are not able to respond to socio-economic needs of the poor in both urban and especially rural settlements. Sure the government has developed squatter settlements like Korangi and Landhi in Karachi but these settlements are not conducive to the needs of the poor. There is no power, no clean water, no safe housing, no sewerage system, no nothing!! What are these people suppose to do with just free land?? Lets turn to private institutions. Sure many have great initiatives for the poor with regards to health centers and water and drainage system but most are for profit only. They make their big bucks and leave the people they claim they are serving. And then there are land mafias who will give the poor everything they need, but a big price. This price endangers their safety as well as that of their family members. One is indebted to them and are required to follow their every command.

Civil society is composed of totally voluntary and social organizations. Community members recognize their own needs and work together to solve their problems. Individuals who are poor take their lives into their own hands to change their present and the future. Community members are empowered and mobilized into action. Khuda Ki Basti is such an example. This is the name given to the colonies located not only in Karachi but Hyderabad and Lahore as well. It literally translates into "God's own land." This housing scheme won the Aga Khan Award of Architecture in 1995. The AKAA jury felt that this model proved to be a successful effort to create affordable housing for the poor and that this model can be replicated elsewhere. This field trip proved to be inspiring and thought-provoking. If you would like to see pictures, go on facebook.

Khuda ki Basti (KKB) is an incremental housing development scheme, located in the slums of Karachi and Lahore. The KKB was actually developed first in Hyderabad and is a joint initiative between the NGO Saiban and Malir District Authority. We visited the Taseer site in Karachi, however. This project is actually a prime example of what civil society should be.

Saiban has purchased plots from the Malir Development Authority, which they distribute to poor families based on their income and family size. This allows individuals and families to settle on land and own a place which they themselves can call 'home' at a price they can afford. The development of the scheme is incremental while the internal services are limited to the basics. At the start only communal water supply and public transportation to the city center are provided however, services such as internal water supply, sewerage, road, electricity and gas are provided as the allotte pay their monthly installments. Speed and standard of development thus depends on installments. The total price of a fully, furnished 80 sq yds plot is Rs 37,500 with Rs 8,000 as the down payment and the rest is paid in installments of 300/month. Once the full price is paid off, the land belongs to the family. With this regard, the project is self-financing without any subsidy from the government or anyone else for that matter. Individual dignity is preserved and their ability to help themselves encouraged.

The great thing is that the families get to design and construct their home with any material or style they can afford. Usually, the first house is made from cheap, raw materials like wood or cardboard. Once families take up permanent residence and generate some income, materials such as brick or cement block is used. These materials are locally available and not bought it from an outside source.


Khuda-ki-Basti is also provided with education and health facilities, both private and public. Families are also privided with affordable transport service. However, I was too happy with the Baqai Hospital (sponsored by another NGO). Sure its nice to offer free services but this is not sustainable. A small amount of user fee can go a long way. Aren't we then undermining individual dignity by giving them charity? Now this hospital gets its funding from profits made by international institutions like Bill and Melinda Gates Foundation. However, what happens when these institutions decide to opt out. Where will the people of Khuda Ki Basti go then?

Either way, this scheme is changing the concept of "katchi abadis" -those living in shanty towns/slums who have no means nor motivation to help themselves.

"Even when governments are fragile, or even nearly paralyzed in their functioning, strong civil society organizations can advance the social and economic order as they have done in Kenya and Bangladesh. Civil society is a complex matrix of influences, but its impact can be enormous, especially in rural environments." - Speech by His Highness Aga Khan at the Graduation Ceremony at University of Alberta, June 2009.

Rumi has a way of speaking to me through his poetry. He speaks to my Soul-my very essence. In fact, his words tend to describe perfectly what I am feeling and my thoughts. I can never articulate the way he does.

And so, I present a poem by Rumi....

Seeking the Source

a voice out of this world
calls on our souls
not to wait any more
get ready to move
to the original home

your real home
your real birth place
is up here with the heavens
let your soul take a flight
like a happy phoenix

you've been tied up
your feet in the mud
your body roped to a log
break loose your ties
get ready for the final flight

make your last journey
from this strange world
soar for the heights
where there is no more
separation of you and your home

God has created
your wings not to be dormant
as long as you are alive
you must try more and more
to use your wings to show you're alive

these wings of yours
are filled with quests and hopes
if they are not used
they will wither away
they will soon decay

you may not like
what i'm going to tell you
you are stuck
now you must seek
nothing but the source

- Rumi