Struggle for Change

The Success Story

BurfatMuhalla is one of the settlement located in Yousuf Goth of UC-7, Gadap Town in Karachi City. It’s population is estimated to 4,500 people. The living style of residents of the settlement was same like other urban slums around the Karachi City. HANDS started working in Yousuf Goth for provision of safe drinking water through sustainable resources with support of WaterAid. Not only for achievement of the object but also to ensure sustainable development, the Water supply schemes are provided with community participation. HANDS was forming Muhalla WASH Committees in each settlement of Yousuf Goth for this purpose. Same was formed in BurfatMuhalla.

BurfatMuhalla Committee Chosen Muhammad Ali Burfat as their chairman to lead the committee. During the norming phase although community faced some major challenges like;

  • Bring all community at one platform and build level of understanding on basis issues of community.
  • Encourage individuals as well as the community to embark on a process of change.
  • Mobilize for the Contribution of community in Water Schemes.
  • Complete water schemes work with the help of community and ensure billing.

With some efforts the community resolved the issues and water supply scheme was provided by HANDS and each household of the area got the tape water in their home.

Apart from project targeted activities community made extra efforts to make some more betterment for their vicinity. They brought the whole community at one platform and mobilized them to identify their own needs and to respond to address these needs through physical or financial inputs.

Following are some the achievement of their struggles;

  • Solution of sewerage issues.
  • Cleaning of Streets.
  • Plantation in streets.
  • White wash on the external wall in whole area.
  • Garbage collection from each HH on daily basis against minimal charges.
  • Continuousefforts the keep safety from garbage and sewerage.
  • Community resolves their electricity problems almost 60% and for remaining 40% community tries to rent out PMT on monthly basis.
  • Promotion of Health and Education.

Now they are doing efforts to make their streets concrete. Their struggle for Change makes their settlement different from others and sat example for others to follow. Other committees, who visited them, are seeking their advices now for change.

case study 1 case study 2 case study 3 case study 4

Guidelines on preparation and Safety procedures during Cyclones

Before the cyclone season

  • Check that the walls, roof and eaves of your home are secure.
  • Trim treetops and branches well clear of your home.
  • Preferably fit shutters, or at least metal screens, to all glass areas.
  • Clear your property of loose material that could blow about and possibly cause injury or damage during extreme winds.
  • In case of a storm surge/tide warning, or other flooding, know your nearest safe high ground and the safest access route to it.
  • Prepare an emergency kit containing:
    • a portable battery radio, torch and spare batteries;
    • water containers, dried or canned food and a can opener;
    • matches, fuel lamp, portable stove, cooking gear, eating utensils; and
    • a first aid kit and manual, masking tape for windows and waterproof bags.
  • Keep a list of emergency phone numbers on display.

When a cyclone watch is issued

  • Re-check your property for any loose material and tie down (or fill with water) all large, relatively light items such as boats and rubbish bins.
  • Fill vehicles’ fuel tanks. Check your emergency kit and fill water containers.
  • Ensure household members know which is the strongest part of the house and what to do in the event of a cyclone warning or an evacuation.
  • Tune to your local radio/TV for further information and warnings.

When a cyclone warning is issued
Depending on official advice provided by your local authorities as the event evolves; the following actions may be warranted.

  • Park vehicles under solid shelter (hand brake on and in gear).
  • Close shutters or board-up or heavily tape all windows. Draw curtains and lock doors.
  • Pack an evacuation kit of warm clothes, essential medications, baby formula, nappies,
    valuables, important papers, photos and mementos in waterproof bags to be taken with
    your emergency kit. Large/heavy valuables could be protected in a strong cupboard.
  • Remain indoors. Stay tuned to your local radio/ Mobile Phone and TV for further information.

On warning of local evacuation
Based on predicted wind speeds and storm surge heights, evacuation may be necessary.
Official advice will be given on local radio/TV regarding safe routes and when to move

  • Wear strong shoes (not thongs) and tough clothing for protection.
  • Lock doors; turn off power, gas, and water; take your evacuation and emergency kits.
  • If evacuating inland (out of town), take pets and leave early to avoid heavy traffic, flooding and wind hazards.
  • If evacuating to a public shelter or higher location, follow LEAs/PDMA directions.
  • If going to a public shelter, take bedding needs, water & food

When the cyclone strikes

  • Disconnect all electrical appliances. Listen to your battery radio for updates.
  • Stay inside and shelter {well clear of windows) in the strongest part of the building,
    i.e. cellar, internal hallway or bathroom. Keep evacuation and emergency kits with you.
  • If the building starts to break up, protect yourself with mattresses, rugs or blankets under a
    strong table or bench or hold onto a solid fixture, e.g. a water pipe.
  • Beware the calm ‘eye’. If the wind drops, don’t assume the cyclone is over; violent winds
    will soon resume from another direction. Wait for the official ‘all clear’.
  • If driving, stop (handbrake on and in gear) – but well away from the sea and clear of trees,
    power lines and streams. Stay in the vehicle.

After the cyclone

  • Don’t go outside until officially advised it is safe.
  • Check for gas leaks. Don’t use electric appliances if wet.
  • Listen to local radio for official warnings and advice.
  • If you have to evacuate, or did so earlier, don’t return until advised. Use a recommended route and don’t rush.
  • Beware of damaged power lines, bridges, buildings, trees, and don’t enter floodwaters.
  • Heed all warnings and don’t go sightseeing.
  • Don’t make unnecessary telephone calls.

Dissemination Impact assessment of Health worker Model “MARVI” report “Understanding MARVI “

Only 20 percent Pakistanis takes benefits from public sector facilities even after the 67 years of independence while Pakistan lags behind in many reproductive health indicators as compare to its regional neighbors, the Contraceptive Prevalence Rate is 35% and only around half of all births are in a health facility or attended by a skilled attendant, this was highlighted in one of the research report launched in Seminar on 16th October 2014 organized by HANDS.

Urdu Pic and Caption

On the occasion of Understanding MARVI seminar Prof. A.G Billoo, Dr. Yasmeen Qazi, Dr. Adnan A. Khan, Dr. Shaikh Tanveer Ahmed, Shanaz Wazir Ali, Dr. Bashir Juma (Sec. Health Govt. of Sindh), Iqbal Hussain Durrani and Bashir Ahmed Mangi (Director General Population welfare department) addressing to the audience

Dr.Ghaffar Billo Chairman HANDS during the Seminar shared with the audience that the Government of Pakistan has attempted to implement a number of initiatives – among which the Lady Health Worker Intervention has stood out as one of the most successful but still the LHWs program could reach to hardly 40 to 60 percent population vary from province to province. Hence there found a huge gap, 60 – 40 percent highly marginalized population vulnerable for ill health which resulted deaths. He further added that in order to address this deficiency, HANDS conceived and implemented, a model of working with no or low literate  rural women to serve their communities with family planning (FP) and reproductive health (RH) services.

While spoke to the audience Dr.Shaikh Tanveer Ahmed CE HANDS informed that the first phase of MARVI intervention initiated from 1st November 2007 with baseline survey. District Umerkot is the poorest district of the country located in Southern region of Sindh Province of Pakistan. Most of the population are living under the poverty line with literacy rate of only 6 percent. Whereas nearly 50 percent of the total population is deprived of Lady Health Worker Services in District Umerkot. Hence this was the reason behind to initiate this project to provide basic health and safe-motherhood services in the area. One MARVI worker and a Dai were selected as per criteria with the recommendation of community groups for 700 to 1000 populations and hence 350 villages or cluster of villages were identified.  The total population benefitted from the project is 400,000 directly and whole district population of 858,000 indirectly. The project mobilized with the assistance the David and Lucile Packard Foundation and in partnership of Local Organization Thardeep Rural Development Program – TRDP and in close collaboration with “District Health and Population Welfare Department” .

Impact of the intervention of the health project at Umer Kot was assessed by an external evaluator Dr.Adnan A.khan, the impact assessment report of the project was presented in the local Hotel today,  The report presented the impact of the 350 Marvi workers (health workers performance) in the district which create a prominent change in the health status of Umer kot district which is the remotest district of Sindh. The report was presented in front of many legislators of Parliament while Health and Population Department representatives were also participated in the event Senator Dr.Karim Khwaja, Secretary Health, DG Health  also participated in the Seminar.  In the technical session of Seminar which was Chaired by Professor Rasheed Juma (EX DG health co- chaired by Dr.Durre Shawar from health department was highlighted that there is significant increase in many of the critical health indicators in Umerkot by creating a new cadre of health workers from uneducated rural area by HANDS.

Report pointed out that the intervention has had a dramatic effect on Marvis at several levels. Their personal monthly incomes nearly quadrupled from around PKR 892 to 4724, while their household incomes have tripled from PKR 4829 to PKR 12362. Interestingly, Marvi work only contributes around PKR 1905 to this income while non-Marvi work – mainly the shop that they have established and promote during their Marvi work – contributes around PKR 2819, suggesting that the entrepreneurial skills and empowerment that they learnt from the intervention have led to wider benefits to Marvis.


These ladies were called the “Marvi” workers, the Marginalized Areas Reproductive Health and Family Planning Viable Initiatives – MARVI approach is centered around empowering local women that is Marvi workers and communities that is women and their families through capacity building to improve RH and FP outcomes with minimal dependence on external aid. Word MARVI considered as dignity and women empowerment, is adopted from the name of a women in folk stories.

The impact assessment of the project proved that the intervention has had a dramatic effect on Marvis at several levels especially in terms of women empowerment and women health status. It is reported that CPR in Umerkot rose from 9% at the baseline to 27% at the end line, or a 3-fold increase and was higher in Marvi served areas. Changes were seen in all areas covered by Marvis where the CPR was over 30%; whereas it remained largely unchanged in LHW areas (10%). Community women ascribed both the higher demand and their own increased use of FP to the work of Marvis. Marvis acted as agents of change by “demonstration by doing” (CPR was 37% among the Marvis themselves), by convincing both men and women to use FP and by making FP supplies available at the doorstep.

Through this intervention not only impact on women health but MARVI as women recognized not only as Community Health Worker but most of them have transformed as a women leader for their communities.  MARVI project has proved that when there is no lady health worker, a low or no literate girl if trained as community health worker with the support of a Lady Health Visitor can mobilize clients of Reproductive Health &FP Services, with the support of community based groups.

The success of MARVI intervention already took her out of the boundary of District Umerkot, to 5 more districts and their number has grown from 350 to 1000. Millions of Pakistani women and children are waiting for her. It is stressed in the Seminar that this model can be replicated in all over Pakistan by department of Health across the country. It was urged to department of health to help HANDS to scale MARVI intervention in the areas, where there is no Lady Health Workers.




Relief and Recovery Project for Earthquake Affected Areas of Balochistan (November 2013 – November 2014)

A powerful earthquake struck Balochistan on 24th September 2013, the quake’s  epicenter was in the Awaran District, but other districts of Balochistan – Kech (Turbat) and Panjgur were also affected. According to reports, the tremors registered were of 7.8 on the Richter scale. After the initial incident, another earthquake of 7.2 magnitude hit the same area of Balochistan on September 28, 2013.

The initial results of rapid assessment done by HANDS & data presented by Provincial Disaster Management Authority (PDMA) Government of Balochistan showed that 42000 families and nearly 300,000 peoples were affected. Around 90% of the building collapsed including shops and houses in 8 Union Councils of District Awaran. The 05 Union Councils of Panjgur & 02 Union Councils of District Kech were also affected from the disaster. According to PDMA Balochistan 399 people were killed and 599 were injured. Dozens of Health & Education facilities, water wells, Karezs were also damaged.

Realizing the pathetic state, HANDS was among the first few not for profit organizations to reach Awaran with philanthropy funding and later 2.5 million Pounds (PKR. 412 million) from DFID / UKAID partnership. We had the honour to meet the Chief Minister of Balochistan and brief him on the “Relief and Recovery Project” and he graciously consented to launch the project. HANDS planned and worked in close coordination with District Administration and Lines Department under the leadership of Deputy Commissioner Awaran and PDMA Balochistan.

Relief Distribution

Relief Distribution

HANDS was founded by Prof. A. G.  Billoo (Sitara-e-Imtiaz) in 1979.HANDS has evolved in 34 years as one of the largest Non-Profit Disaster Management Organization of the country with integrated development model. HANDS has a network of 32 offices across the country and has access to more than 16.2 million population of nearly 20,274 villages/ settlement in 35 districts of Pakistan. HANDS strength is 18 volunteers Board Members, more than 1700 full time staff and thousands of community based volunteers of 5205 medium and small size organizations.

After the conduction of “rapid assessment” of the affected, a plan was developed to reach 10,000 households and 56,000 individuals through the project in earthquake-affected districts of Balochistan. The project reached to communities of 08 worst affected union councils including Awaran, Gajar, Nokjo, Teertej, Parwar, Gishkore, Chitkan (Panjgur), Dandar (Kech).

HANDS believe in community participation and worked with group methodology and thus 400 Community Support Groups (CSGs) were formed. Each group comprised of nearly 25 beneficiaries.

Realizing the immediate needs of targeted communities in the relief and early recovery phase of the earth quake, HANDS distributed 10,000 emergency shelter roofing kits (bamboos, plastic sheet and ropes), 20,000 blankets, 10,000 ceramic filters & 10,000 solar lights to the affected as per their need assessment.

Providing health services in the effected areas

Providing health services in the effected areas

In the health sector the contribution of HANDS included 07 mobile medical mobile teams sent from Karachi to provide health services to 27,000 sick and injured people. Emergency Health Care services package included maternal & Child Care, physiotherapy of injured patients, rehabilitation of disabled through developing a cadre of Community Health Worker. We also distributed 50 wheel Chairs to the disables. HANDS also in process 02 Hilux ambulances to the District Health Administration and solar energy source to maintain the cold chain of vaccines for 05 health facilities including District Head Quarter (DHQ) Hospital Awaran.

Child friendly centers to revive educational activities

Child friendly centers to revive educational activities

In the education sector, considering the urgent needs of District, 25 Child Friendly Spaces (CSF) were established. Learning material and sports material was provided which played a vital role to increase the interest of children. The change environment probably attributed to the increase in enrolment up to 1,469 children. One teacher from each school was trained and equipped with psycho social well-being skills. Water, Sanitation and Hygiene (WASH) services were provided at 25 targeted locations of Govt. schools along with provision of furniture and learning material.

Low cost one room shelter built in the area

Low cost one room shelter built in the area

HANDS in recent year has developed and excelled in providing low cost shelters in disaster affected areas. Through its Infrastructure Development Energy WASH and Shelter (IDEAS) program arranged to deliver the knowledge and skills at local level for construction of disaster resilient shelters through conduction of orientation session to community groups. The project provided the opportunity of “Cash grant” through bank transaction of PKR 49500 per family to 4500 families to build shelters. Cash grant of PKR 223 million is in transfer process.

HANDS also intervened on the livelihood aspect and “Cash Grants” for 1200 livelihood schemes to benefit 10,000 community members is in process as livelihood enhancement support. Out of 1200 schemes 32% are water related, 28% – Cleaning & Hygiene, 1.4% – Community Physical Infrastructure (CPI), 11% Handicraft and 10% Shelter. HANDS also enhanced the livelihood of Community groups through supplying 800 tool kits each of which comprised of 6 tools to be used in agriculture and non-agriculture labour. The intervention is still in the process and 63 million cash grant will be disbursed till the end of project period.


HANDS ensured the transparency by signing an agreement with United Bank Limited for on line cash transfer direct to the beneficiary on presentation of National Identity Cards (NIC). HANDS has also established and on line complaint mechanism name “Suggestion And Complaint (SAC)” system to give a direct access for all complaints to Chief Executive Secretariat for sharing of any concerns and grievances through telephone, letter, messaging or emails.

HANDS Monitoring & Evaluation Program also hired “Balochistan Engineering and Technology University Khuzdar” as 3rd party monitors, after signing a Memorandum of Understanding (MOU). The Monitoring & Evaluation Program also made it mandatory to different cadres of staff to make monitoring field visits to ensure timely sharing of challenges, smooth implementation and sharing of monthly progress.

HANDS requires your generous support to continue these efforts, to make our dream come true through Rebuilding Balochistan affected areas and achieve vision of “Healthy, Educated, Prosperous and Equitable Society”. Millions of Balochi women, Children and survivors are looking forward to us. Let’s work together to give them a ray of hope.

HANDS Emergency Response for flood affected people of Punjab – 15th September 2014

HANDS Update from District Muzzafar Garh, Sialkot, Mandi Bahauddin,

Hafizabad, Chiniot and Jhang.

HANDS Pakistan:

HANDS was founded by Prof.A.G.Billoo (Sitara-e-Imtiaz) in 1979. HANDS has evolved in 34 years as one of the largest Non-Profit Organization of the country with integrated development model. HANDS has a network of 30 offices across the country and has access to more than 16.2 million population nearly 20,274 villages/ settlement in 34 districts of Pakistan. HANDS strength is 18 volunteers Board Members, more than 1502 full time staff and nearly one million community based volunteers of 5205 medium and small size organizations.

HANDS has a vast experience to deal with Emergencies during the recent disasters in the country.        

  1. IDPs of North Waziristan Agency 2014: Emergency Response was initiated within 36 hours to provide assistance to IDPsand Services are still continuing at Bannu, KP.
  2. Drought in Tharparkar in March 2014: Emergency Response was initiated within 5 hours and Relief package was provided to 6,000 families in 2 months.
  3. Earthquake in Awaran Balochistan in October 2013: Emergency response was initiated within 8 hours & comprehensive relief package was provided in hard conditions and conflicted areas within two months to 10,000 families.
  4. Rain Emergency 2012 in Northern Sindh, South Punjab & Balochistan:Emergency response was initiated within 6 hours. Distribution of emergency relief package was provided to 27000 families within 2 months
  5. Rain Emergency 2011 in Southern Districts of Sindh: Emergency response was initiated within 8 hours in 8 districts. 29000 families were reached within 2 moths
  6. Flood Emergency 2010: Emergency response was initiated within 4 hours in northern Sindh & 36,000 families were reached within 1 month.

 Flood Updated situation in Punjab and Sindh.                                                     The heavy water flow moving towards Guddu  after passing through Panjnanad (Rojhan) Rajanpur, Flood waters are rising in Sindh at Guddu barrage in Kashmore district. The current water flow is indicative of high floods and is expected to peak sometimes tonight. According to Pakistan Meteorology Department the expected flow of water would be between 400,0000 -500,000 cusecs. This water will start reaching Sukkur barrage in next 24-36 hours. PDMA Sindh have issued flood alerts  on Sep 6th, 9th and 12th, 2014, to district administration in the six northern riverine district to evacuate people living in Katcha areas [Riverbed]. These districts include, Kashmore, Ghotki, Shikarpur, Sukkur, Khairpur and Larkana.

As per media reports and district flood control centers and HANDS assessment the evacuation is now complete. People moving out of katcha areas have taken shelter on the river embankments. According to district flood control centers people are reluctant to settle in tent cities, because they want to stay near their homes and return as soon as the water recedes.

HANDS Assessment:

HANDS Pakistan started Initial assessment to rescue the people who had not access to reach on safe places, teams contacted to District Government for the rescue activities and they supported us by providing authentic information regarding stucked people in flood on different places.

Recommendation for immediate early response:

  • Provision of Food Items and Non Food Items except tents
  • Medical health teams are required along with medicines for skin diseases, wounds, acute respiratory infections especially for children, malaria etc.
  • For clean draining water Aqua tabs are required.
A view of planning meeting

A view of planning meeting

 MIRA Assessment in flood affected districts of Punjab: 

In order to assess the damages in the most affected districts NDMA in collaboration with UNOCHA has already initiated work on Multi Sector Initial Rapid Assessment. The assessment would be carried out in most affected districts that includes Mandi Bahauddin, Hafizabad, Chiniot, Jhang and Multan as identified by the PDMA Punjab. In this regard, a coordination meeting was also held today to devise final coordination mechanism and identify field coordinators to move in the identified affected districts for active management and timely completion of the task. NDMA would coordinate and facilitate UN system/NGOs in carrying out this assessment. HANDS Pakistan is alsothe part of MIRA assessment in all mentioned districts of Punjab

HANDS Emergency Response for flood affected families of Muzzafar Garh, Chiniot, Rajanpur  and Jhang.

HANDS Pakistan has started its Emergency Response for affected families of Punjab flood affected families initially its own resources.

Coordination Meeting with Different Government Officials:

Coordination Meetings were conducted with the different Government Officials like PDMA, DDMAs, line departments, Emergency Coordinators, district clusters, Media representatives and UNOCHA.

Evacuation of Affected People:

HANDS Pakistan initiated emergency response in flood and they started evacuation affected families and more than 700 families were shifted to safe places in District Muzzafar Garh.

HANDS initiated emergency response in flood

HANDS initiated emergency response in flood

food package

Food Distribution in flood affected districts of Punjab:

HANDS Pakistan observed that there is need of Food in the affected areas of Punjab also started the food distribution from 14th September 2014 in 03 villages of Bhawana and Lallian Tehsils of district Chiniot with the facilitation of Ujala Welfare Trust.

Food distribution among flood effected people of Punjab

Food distribution among flood effected people of Punjab

Mobile Medical Services in flood affected districts of Punjab :

HANDS initiated health services through conduction of Mobile Medical Camps with support of District Government Chiniot, Sialkot, Jhang and Rajanpur. HANDS Medical teams have started the medical services from 12th September in Tehsil Bhawana & Lallian of Chiniot district and Tehsil Sambrial of Sialkot district with the facilitation of Ujala Welfare Trust and Young Blood Foundation. 863 Patients have been treated by HANDS Medical team and 499 patients out of them were female.HANDS teams have planned health education sessions on Health & Hygiene in the IDP camps at and different places in different UCs of District Chiniot, Sialkot, Jhang and Rajanpur.

medical camp 2


Installation of  Emergency latrines in relief camp established by district Government Kashmore @ Kandhkot:

HANDS Pakistan received request letter by district government Kashmore regarding the HANDS technical support in installation of tent city (relief camp) , provision of emergency latrines in relief camp  as well as support in evacuation .On the bases of request by  district government HANDS Pakistan , provided boats, HANDS Mazda for safely evacuation of flood affected families and provided 20 emergency latrines and  installed at relief camp.


Chief Executive HANDS Pakistan Visited flood affected districts of Punjab :

The chief Executive HANDS Pakistan Dr Shaikh Tanveer Ahmed visited flood affected districts of  Punjab and monitored ongoing relief operations by HANDS and conducted, during visit he conducted meetings with Government authorities, media representatives, community activist and HANDS teams.

C.E Visit 3

HANDS Pakistan contacts information:

Dr. Shaikh Tanveer Ahmed, Chief Executive ‐ HANDS Pakistan

140‐C, Block‐2, PECHS, Karachi, Ph: 021‐34527698, Cell# 03008200507

Email: , Website:

Donations: HANDS Account No.003800613865-03 (Habib Bank Limited)

HANDS Zakat Account No. 003800705395-03 (Habib Bank Limited)


Dr. Muhammad Sarwat Mirza – Chief Research & Development Executive, HANDS Pakistan

HANDS Islamabad Office, Office 1, Block-5, Saidpur Market, Sector G-7/1, Islamabad

Ph: 051-2606482; Fax: 051-2606483, Cell# 0300-8297503

Email:, Website:


Muhammad Raheem Marri, General Manager ‐ Disaster Management Program HANDS

140‐C, Block‐2, PECHS, Karachi, Ph: 021‐34527698, Cell# 0346‐8209561

Email: , Website:


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