December 1, 2005

In recent years, Pakistani citizens have donated an amount equal to 1.25 per cent of the nation’s GDP. The government spending on social services meanwhile decreased to 3.4 per cent in 2000. The Social Policy and Development Centre recommends that in poverty-stricken environments such as those that exist in developing nations like Pakistan, 20 per cent of public expenditure should be on social services, writes Khadeeja Balkhi

In 2000, Pakistanis gave $1.2 billion, or Rs67.7 billion, in charity. Pakistan is ranked the sixth most philanthropic country in the world, according to the Pakistan Centre for Philanthropy (PCP). The PCP’s pioneering study in 1998 showed that total giving by individuals was equivalent to 17 per cent of the year’s national revenue. Pakistanis deserve a collective pat on the back. In recent years, Pakistani citizens have donated amount equal to 1.25 per cent of the nation’s GDP.

The government spending on social services meanwhile decreased to 3.4 per cent in 2000, according to the United Nations Development Programme(UNDP). The Karachi-based Social Policy and Development Centre recommends that in poverty-stricken environments such as those that exist in developing nations like Pakistan, 20 per cent of public expenditure should be on social services. Given Pakistan’s monetary resource limitations, it is vital that the government spending extract more value for money.

Welfare organization Edhi Foundation has become a household name, working on international level as well. Its international services ranges from relief to the needy in the civil war in Lebanon during 1983; to aid to earthquake victims of America and USSR during year 1989; to aid for the affected people and refugees of the Persian Gulf war during 1991 in the form of blood, plasma, medicines and surgical equipment, etc, worth approximately Rs4.5 million; to continuous relief operations including provision of transportation facilities to Bosnian refugees during 1993-94; to supplying food to Mogadishu in Somalia during 1993 in collaboration with the Pakistan army; and even Rs6,000,000 in aid to Katrina victims. The list is endless.

Like most organizations in Pakistan, Abdul Sattar Edhi started from scratch. In the early 1960s, he bought his first ambulance, an old van which he called the “poor man’s van.” Edhi combed Karachi providing medical help and burying unclaimed bodies. His van became a symbol of his dedication and tireless efforts for the poor and from there he has become an international figure.

The Edhi Foundation is now listed in the Guinness Book of World Records as the world’s largest volunteer ambulance service. His ambulances include air ambulances and together they transport over one million people annually.

The foundation’s all-embracing activities include comprehensive 24-hour service across the country through 300 Edhi centres. It is home to over 6,000 destitute and 50,000 orphans. Another 15,000 orphans have been placed with adopting families, after personal approval from Bilquis Edhi.

Nearly 20,000 abandoned babies have been saved by the foundation, many through the initially controversial jhoola programme. Jhoolas or cradles, are installed at most of the Edhi centres so that unwanted children can be anonymously abandoned there instead of throwing them in the garbage dumps.

Another one million babies have been safely delivered at Edhi maternity centres. In addition to others, women-specific departments are run by Bilquis Edhi – and her husband has publicly credited her with being responsible for no less than 70 per cent of Edhi Foundation’s achievements.

The foundation has trained over 40,000 nurses ——- Bilquis and Abdul Sattar Edhi got married after they met at the foundation’s initial nurse training efforts.s.

Similarly, the Alamgir Welfare Trust was established 11 years ago with the simple idea of collecting food wasted at weddings. Its daily expenditure is now about Rs0.25 million and through its medical wing it treats 500 patients free daily. Among its social welfare activities include distribution of 1,000 of ration packets monthly.

In a country where 80 per cent women are victims of domestic violence at some point in their lives, they are one of the largest segments of Pakistan’s society in need of empowerment.

There is hardly a shortage of NGOs working on women’s issues. The All Pakistan Women’s Association for example is one of the three national organizations that is granted consultative status with the UN. The UN has been evaluating and renewing the status every four years since 1952.

Apwa has educated 120,000 women and girls through its basic and technical educational programmes. It has successfully touched the lives of thousands of women and children through its health, legal aid and jail projects.

However, according to the Human Rights Commission of Pakistan, more than 99 per cent women in NWFP’s tribal areas were illiterate in 2002. Just over three per cent women in Balochistan were literate in 2003. Many women have stated that the core of the problem lies with the attitudes men have towards women.

The long-term solution thus lies with a paradigm shift in the gender conceptions of men –— especially given how patriarchal the world still remains. And this is where educational and awareness building programmes must focus.

Although there are many organizations that are providing healthcare to women, their efforts will bear results only when they simultaneously address the root causes behind the un-empowered status of women in the society.

For this purpose, crisis control institutions exist, however, most of them do not address the root causes. Among these are organizations that provide shelter to victims of physical abuse and domestic violence. What is largely un-catered for in the NGO sector are initiatives aimed to educate and rehabilitate the perpetrators and to hold them accountable for their crimes.

Acknowledging the work that has taken place in this area, there is yet an ocean of grassroots work and systematic change that needs to be chartered by committed citizens.

“There are wonderful human beings and organizations that help you pick up the pieces of the broken glass and put them back together,” says Naureen, a victim of domestic violence who received help fighting for custody of her children and divorce. “But not nearly enough exist who have the foresight and the courage to ask, ‘who broke the glass’,” continues Naureen.

In a country where one third population has no access to health services, only one per cent of the government’s budget has been allocated to healthcare. The civil society has risen to the challenge. The largest donations from the corporate sector have been given to healthcare that is nearly 30 per cent.

While holistic healing remains an elusive concept to implement even at hospitals for the elite, RahatKada started caring palliatively for terminally-ill cancer patients 15 years ago completely free of cost. In addition to all other medical specialists, there is a psychotherapist for each patient. Its founder Dr Saira Khan insists on dignity in death for the 9,000 patients who have so far benefited from the cancer hospice.

Similarly part of the Layton Rahmatulla Benevolent Trust’s (LRBT) ethos is that “charity does not mean second grade treatment,” according to Saquib Hameed, Managing Trustee at LRBT. “We have better equipment than private hospitals. Nearly 80 per cent of all blindness is curable,” he adds.

The LRBT’s bottom line is “to not allow any citizen to go blind because he or she cannot afford treatment,” says Hameed. The Trust has so far helped reduce the occurrence of blindness by 42 per cent in Pakistan — having treated about 11 million patients to date.

LRBT performs 26 per cent of all cataract surgeries in Pakistan where 53 per cent of curable blindness is due to cataract. An operation that costs LRBT Rs1,500, can transform a blind person into a productive member of society. Thus the World Health Organization rates eye-care among the top ten most cost-effective forms of medical intervention.

The Sindh Institute of Urology and Transplants (SIUT) meanwhile performed Pakistan’s first successful liver transplant in 2003. After three years of developing an intensive liver transplant programme, a six-month old baby was transplanted. The baby’s maternal uncle donated a portion of his liver for the operation.

SIUT was also the first in Pakistan to perform a cadaver kidney transplant in 1995. The organ was retrieved from a 14 year old Dutch girl who died of cerebral hemorrhage and transplanted into a 24-year-old Pakistani woman in the last stage of renal failure.

Pakistan is the ninth Muslim nation where cadaver organ donations and transplantations have become a successful practice. In 2004, SIUT treated about half a million people, free of charge.

Also free, are the Fatimid Foundation’s facilities that provide 72 per cent of all of Pakistan’s comprehensive thalassaemia — the cause of anemia — treatment. The Hussaini Blood Bank and Thalassaemia Society Rawalpindi tie in at second, treating six per cent of the nation’s patients. The Fatimid Foundation also transfuses 10,000 bags and supplies 21,000 pints of healthy, screened blood and blood components every month; treating 11,700 patients in 2004.004.

Funding and volunteerism
National bank accounts automatically deduct $70 million in zakat from depositors, which has been reported, ironically, by the Christian Science Monitor.

Nearly 65 per cent of LRBT’s Rs210 million funds are generated from within Pakistan. The Pakistan Bait-ul-Mal and Central Zakat Foundation also contributed between three to four per cent of LRBT’s annual budget. The largest chunk, however, comes from the UK-based Sight Savers International.

On the other hand, 99 per cent of the Edhi Foundation’s funds are from private donations within Pakistan. In line with Edhi, 96 per cent of The Citizens Foundation’s funds are also from Pakistanis.

“Nearly 80 per cent of TCF’s funds are from within Pakistan,” says Ahsan Saleem, co-founder of The Citizens Foundation. “Of the remaining 20 per cent, about 80 per cent are again from Pakistanis living abroad.”

Both organizations are able to maintain tight administrative budgets partially thanks to a high-level of volunteers. In 2004, 200,000 people volunteered their skill sets in Pakistan on a full time basis, according to the PCP.

The LRBT’s most recent administrative budget was 4.8 per cent of its total budget. “Every one of the fundraisers is also a volunteer,” says Hameed. “They give their time and skills very generously,” he adds. The TCF, meanwhile, also maintains its administrative costs between five to eight per cent. “We have a large number of volunteers at various levels,” Saleem says.

Although it hires 2,000 teachers to teach the over 30,000 children currently enrolled in TCF schools, there are many high-level retired executives helping with auditing, accounting and human resource management. Most of TCF’s support chapters are supported by women volunteers who are involved in fund-raising and awareness building. Students help out at events and summer programmes.

“This of course is a chicken and egg situation,” says Hameed referring to volunteerism. “I think a fair number of the better NGOs such as The Kidney Centre, Shaukat Khanum, TCF and others have worked very transparently and have created an efficient and effective image — and the result is that skilled people volunteer their services with them."

The Orangi Pilot Project (OPP), for example, has partnered with local governments to help them use their money more effectively. Not only that but it has showed them how to improve communities within their own limited budgets –—- effectively cutting the often inefficient and controlling strings of foreign creditors.

Through its Youth Training Programme (YTP), OPP has also documented, mapped and digitized 60 per cent of the nation’s katchi abadis. Over nine million people live in katchi abadis in urban Pakistan and another 15 million in the informal subdivision of agricultural land, according to Arif Hasan, the chief consultant of the OPP. The YTP’s work means that other urban planning organizations no more have to use the decades old maps that have not been effectively updated.

To date in Orangi, Karachi, 95,500 households have built their neighbourhood sanitation systems by investing Rs90.3 million — 14 per cent of the investment the local government would have made for the same work. In ten years, the infant mortality in the areas where sanitation systems have been made also fell 71 per cent.

The reality is that NGOs very rarely can afford to pay high wages, “You, therefore, have to rely on expertise of the volunteers,” Hameed points out. At the same time, he adds, another way to contribute to the nation is via training employees with professional skills.

“What we really brought to LRBT was our very good managerial skills coupled with passion,” says Hameed, former chairman of a tobacco company who has been managing the Trust for two years. “That’s a winning combination”.

However, the largest obstacle to such NGOs maximizing their potential is still a lack of funding. LRBT, for example, got about three quarters of the way to its ambition of having a facility within a hundred miles of every Pakistani. However, expansion must be sustainable. “The thing which has always restrained us is funding”.

Environmental
Addressing environmental issues has rarely been on poverty-stricken countries’ front burners. The public generally tends to lack awareness regarding effects of environmental degradation on their lives. The long-term environmental efforts require perhaps more prolonged levels of persistence than direct human development efforts do.

One of the World Wide Fund’s (WWF) recent and most popular programmes has a success rate of 0.1 per cent. Over the past five years, the marine turtle conservation project has so far rescued and released over 50,000 back into their natural habitat: the sea. Of these, only fifty, 0.1 per cent, are likely to survive given natural and human dangers.

Yet qualitatively, the project has successfully brought about an attitude shift in locals’ appreciation of their environment via concentrated grassroots awareness programmes and school campaigns.

Corporate sector contribution
Like many NGOs, WWF’s efforts are extensively supported by corporations in Pakistan.

Institutional philanthropy is vital to being recognized as a dedicated corporate citizen —— an increasing concern among Pakistani companies.

In India for example, corporate philanthropy totaled at $46 billion in 2001, according to the Charities Aid Foundation. Thus, 83 per cent of the Indian companies were involved in social development.

In Pakistan, however, that percentage has drastically dropped to 64 per cent in 2004 from 93 per cent in 1998. The total corporate funds donated in 2002, for example only added up to Rs600 million, according to the PCP.

This may be partially due to the low level of trust that persists in Pakistani society. Although 56,200 Non-Profit Organizations are registered in Pakistan, a majority of corporate funds are donated directly to recipients. In 2004, 51 per cent of corporate funds were directly donated, and this number has been slowly rising. Direct giving requires significantly more resource investment — which may have served as a deterrent to some companies. Nearly 28 per cent of the funds were channeled through NGOs or other organizations.

 

A cancer hospital in Lahore

L ahore had a tradition of philanthropy in the pre independence period with Sir Ganga Ram setting up a hospital with his own money, but it fell by the wayside in the ratrace following the establishment of Pakistan. However, gradually the spirit of charity has been revived by a few individuals and groups fired by the zeal to serve humanity. Mian Mohammad Munshi, a relatively small businessman built and equipped a hospital on Bundha Road with his life’s savings in the late eighties and then handed it over to the government because he did not possess resources to run it. The tradition was revived by Imran Khan the captain of Pakistan’s World Cup winning team of 1992, who was upset because his mother, a cancer patient, could not receive proper treatment for lack of facilities for cancer in Pakistan. That galvanized him in conceiving and pursuing a project for setting up the first cancer treatment hospital in Pakistan. Imran did not have financial resources to build and equip the hospital costing 22.2 million dollars but with his popularity at its zenith after the World Cup success, he managed to collect funds from the general public that demonstrated tremendous receptiveness for the idea and enthusiastically welcomed the man who had the status of a national hero. Imran modestly says that the hospital was built and it is being run by the generousity of the people but needless to say he has been the central figure behind the project. SKMCH has treated about 50,000 patients since its inception, over 75 per cent of them free of cost with an approximate expenditure of three billion rupees over the years. The annual of the hospital of 1.04 billion rupees is generated upto 45 per cent by the hospital’s own resources while the rest comes from selling diagnostic facilities, paying patients and Zakat donations. The hospital is equipped with the latest state of the art machinery and serves patients across the country. But Imran Khan feels that just one such hospital is not sufficient for the people of Pakistan and has embarked on the construction of another similar project in Karachi. While SKMCH is a milestone development in charitable work in itself, its importance has to be seen in the snowball impact on the revival of charitable causes. Imran has actually been a catalyst for such activities and has been a role model for many young personalities, singers and artists in particular, who have taken up similar health care causes and are building facilities for the poor in many cities to fill the vacuum in a sector that used to be the government’s responsibility. But successive insensitive administrations of Pakistan abdicated their role to promote commercialism. It is the efforts of Imran and individuals who are emulating his example that has recreated hope for the sick among the poor of Pakistan. —Zafar Samdani

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