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Naima, a 26 year old Afghan woman suffering from a physical disability she was born with, lives with her family in the Refugee Camp of Khaki District in Mansehra, Pakistan. She has two elder brothers who work as daily wage labourers, earning PKR 300 (US $ 1.78) a day. Their father is unable to work due to his old age and their mother is too weak to engage in any form of labour either. The family has been living in Pakistan since 1980 when they fled the war in Afghanistan.

“Naima was born a normal, healthy baby. But by the time she turned one we noticed that she could not move, crawl or try to stand. Both her legs started to look a bit unusual. We hurried to the closest doctor to get her checked. The doctor advised us that it would heal with time as she grew.  Sadly, just the opposite occurred. Her legs became more and more incapacitated with time and she could not walk at all,” shared Naima’s mother.

“To help us in any little way that she could, Naima started weaving from an early age and always helped us with small household chores. In 2017, Naima experienced another setback. Her right hand started showing signs of impairment which meant she was unable to move it much and eventually she couldn’t even engage in the activities that kept her busy and provided us financial support.”

In 2012, Naima’s sister-in-law was diagnosed with cancer. The family took her to a cancer hospital in Lahore, but she was refused treatment there due to her refugee status. She was then admitted in a private hospital in Lahore.

“We had to take a loan for the treatment of my daughter-in-law. We also received donations from our in-laws and community elders. Despite the generous donations, we were unable to afford all the expenses incurred at the private hospital. We were already unable to cover Naima’s medical expenses so this additional expense came as another burden on our shoulders.

Due to COVID-19, there are barely any work opportunities for my sons and we are all struggling to make ends meet. The family has not earned a penny since the lockdown in March. With a disabled daughter and an unwell daughter-in-law, it has become extremely difficult to manage our household expenses and put food on the table three times a day,” expressed Naima’s father with grief.

Community World Service Asia and Street Child – UK, with the support of the Commissionerate for Afghan Refugees (CAR) in Pakistan, conducted cash distribution activities under a ‘COVID-19 Rapid Response for Afghan Refugees in Pakistan’ project. As a project participant, the cash assistance provided to Naima’s family has brought some relief to the family.

“No organisation has come to our help. CWSA has been the first to respond to our grievance request. Upon receiving the cash support, I purchased food items and some medicines for Naima and my daughter-in-law. This support has provided some comfort for our families, as there was no source of income coming at home,” thanked Naima’s mother.

Ghulam Sher is a 45-year-old father of eight children, who migrated, along with his family to Pakistan as an Afghan refugee in 1980.  He was only five years old at the time. Today, Ghulam Sher has eight children of his own and they all live together in the Afghan Refugee Camp located in Khaki, Mansehra district.

At the age of eight, Ghulam Sher suffered from a paralysis which followed a severe case of typhoid that went untreated. This left him completely paralysed from down his waist for a long time. After undergoing a lengthy therapy, Ghulam Sher was able to move his arms and hands, but one of his legs and limbs remained paralysed for life.

Ghulam Sher verifying his token at the cash distribution activity.

“I did not lose hope in life. I learnt embroidery skills and started doing embroidery on men’s wear. Since the age of 15, I have been earning a sufficient income for my family through this work. However, when Afghans were requested to repatriate things became difficult for us here and we were left in an economic crisis. Many Afghan families were sent back to Afghanistan from the camp which meant I lost a lot of my clients and the demand for my products fell drastically. Eventually there was not much work left for me to do.

Shortly after, I set up a scarp shop, selling waste plastic pieces and tins which were collected and sold to me by local children. The earning was close to nothing but we were trying to survive.

Two months ago, I bought two large gas cylinders and started a small gas refilling business that would cater to domestic households. This helped me earn PKR 6000 (Approx. USD 37) monthly which was just enough to bear the minimum family expenses,” said Ghulam Sher.

Since a country-wide lockdown was imposed, Ghulam Sher’s business also had to be shut down at end of March, 2020. The restrictions on visiting households and delivering the gas refills personally lead to him discontinuing his services. Due to his physical disability, he was not able to find another job to earn an income either. His family was left without any livelihood.

To address this challenge, Community World Service Asia with the support of Street Child initiated a ‘COVID-19 Rapid Response for AR in Pakistan’ program in May. Under this project, cash vouchers were distributed among 150 Afghan Refugee families residing in Khaki Refugee Village of District Mansehra. The cash assistance intended to help one of the most vulnerable communities of Pakistan overcome the many challenges they were facing during the current pandemic.

Families who had lost their livelihoods amid the crisis, included 27 widows, 83 poor daily wagers, 4 orphans and 36 PWDsⁱ were nominated and verified by the Commissioner Afghan Refugee (CAR) office through UNHCR and NADRA database for the project. The distribution activity was conducted in a strict controlled and safe environment that ensured all precautionary SOPs were followed. Staff and refugee community members maintained social distancing and all stakeholders wore essential protective gears. To avoid cluster gathering, 12-15 families were called at the distribution point at a time at different time slots. Each family received PKR 12,000 (in line with Government of Pakistan’s AHSSAS Emergency Cash Program) after being presented with a token issued to them prior to the distribution. The head of Refugees Elders (Shura) Khaki, Refugee Village Administrator (RVA)/ Security in-charge District Administrator office Mansehra and a representative of Community Development Unit (CDU) from Commissioner A/R office were present during the distribution activity.

According to UNHCR, Pakistan hosts approximately 1.4 million registered Afghan refugees, approximately 68 percent of whom live in urban and semi-urban areas alongside Pakistani host communities. Half of the refugee population lives under the poverty line. Most of those who had employment, as daily wagers, have now been laid off as a result of the COVID-19 outbreak. Ghulam Sher was one of them.

“My elders who live here nominated me as a project participant in the COVID response project as they knew I was not able to find sufficient work because of my disability. I received PKR 12,000 under the rapid relief project. I plan to purchase essential food items and other necessities for my family. I will also pay off some of the loan I had taken to establish my shop.”


ⁱ Persons with disabilities

Photo Credit: Ali Hashisho/REUTERS

As a child immigrant of 5 years old, from Afghanistan’s Paktia province, Bibi Zahra, made the refugee camp in Mansehra Khaki, Pakistan her home for the last thirty years. She is now 35 years old and a mother to four children of her own. Her husband succumbed to cancer three years ago which has left Bibi Zahra a struggling, single mother in a foreign land.

Before the coronavirus pandemic, Bibi Zahra and her eldest, 8-year-old daughter earned a monthly income of PKR 5000 (Approx. USD 32)through household cleaning work in the local neighbourhood. They cleaned dishes, served tables, washed clothes and other such domestic chores for a living. The income they earned was not much but it helped the family survive on a day-to-day basis. However, the COVID-19 crisis has further strained the family with more financial challenges and has even deprived them of a single decent meal.

Since there is widespread fear of the coronavirus being highly contagious, most homes in the neighbouring community have barred part-time domestic workers from entering their houses. Many local businesses are also suffering and cannot afford to offer credit services to their regular customers. Similarly, local shopkeepers are no longer providing credit services to Bibi Zahra to purchase essential food and household items. Many families like Zahra’s are left to depend on the in-kind or financial support of family and friends, whenever that is.

“I’m feeling helpless right now. I have no choice but to expect help from others. Neither the government nor any agency has offered any assistance. These days, I can hardly place food on the table for my children.”

Bibi Zahra confessed she faces a lot of mental stress because of the increased anxiety about the future of her family. She cannot even afford to buy her own medication at this point.

“I know only that this virus is extremely contagious and can be spread easily from one person to the next. I do not have protective items such as sanitizers or virus-protecting masks for myself or my family. I have barely enough money to purchase soap. I am more concerned about the well-being and safety of my children. Since my children barely get a proper meal a day, their health will suffer and they will become less immune to the deadly virus.”

As a result of the pandemic, their lives are at stake. Bibi Zahra spends every day worrying about the future of her children.

An awareness session on food and water hygiene was held in the Community World Service Asia Mansehra office and in three of its Basic Health Units in Barari, Khaki and Ichrian in celebration of the World Health Day on April 7, 2015. The discussions of the day were centered on the importance of consuming hygienic food. Community members were made aware of the many food borne illnesses that are prevalent due to lack of proper food management and unhygienic nutritional consumption.

Health experts from the MNCH Project team physically demonstrated the difference between hygienic and unhygienic food. They displayed how some food may appear to be safe for consumption but actually would not be. They taught ways of how community members could identify these food contaminations that otherwise go unnoticed, and sanitize their sustenance in a way that would make it safe for their consumption. As this year’s World Health Day’s international theme was “food safety”, the activities conducted in Mansehra focused mainly on the emerging health problems and diseases caused by unhygienic food consumption. A great emphasis was laid on the considerable amount of improvement in living conditions of communities if all individuals started being conscious of food safety.

The team based their awareness sessions on WHO’s guidelines on safer food and on how community members must incorporate these in their homes and villages. The five key points of the guidelines were to keep clean; to separate raw food from cooked food; to cook food thoroughly, to keep food at safe temperatures and to use clean water and cooking utensils.

Community World Service Asia celebrated the World Health Day to promote the “FROM FARM TO PLATE, MAKE FOOD SAFE” global campaign in an effort to streamline food safety through its projects and among the communities it works with.

Noor Elahi, age 29, is a resident at the Afghan refugee camp in Khaki, Mansehra. Being the sole breadwinner, supporting a family of eight members, including his five children, became challenging for Elahi after his father’s death. “I was distressed when my father passed away since I was dependent on him. Now I don’t have any other means of income.” Working hard to make ends meet, Elahi began to work as a laborer on daily wages until he was selected as a trainee under the Vocational Training and Market Development Program to learn carpentry skills.

Foreseeing a bright future, Elahi enthusiastically participated in a four month training program. To encourage participation, trainees were paid a stipend of PKR.150 per day including lunch and refreshment. Upon successful completion of the training he received a certificate along with a tool kit to practice his learning. In addition, he acquired a job as a partially skilled laborer at a local carpentry shop which further increased his earnings. To build upon his capabilities and learn advanced techniques, Elahi was selected for a one month refresher course.

“I was satisfied about my future to some extent and was pleased to know about the advance course offered by Community World Service Asia (formerly CWS-P/A). I happily participated in the course to enhance my skills and learned to operate 5 in 1 woodworking machine.”

Considering his expertise and his passion to progress as a professional carpenter, Elahi was selected by the Community World Service Asia (formerly CWS-P/A) team for Small and Medium Enterprise program along with another Afghan graduate. They were also provided a 5 in 1 woodworking machine to launch their own shop. “Together we are working very hard and generate a profit of PKR.15, 000 per month which is equally divided between us. Now, we also have an opportunity to share our knowledge and learn new techniques from each other. We provide economical services to our community members at their door step and also plan to expand our business to a larger scale. I am very thankful to Community World Service Asia (formerly CWS-P/A); because of their extensive assistance I can now support my family easily.”

To support the rehabilitation of refugee communities in Pakistan, Community World Service Asia (formerly CWS-P/A) is implementing a Vocational Training and Market Development Project in Mansehra and Haripur as Gifts of the United States Government since 2010. The goal is to enhance self-reliance and increase income for men and women of Afghan Refugees and host community. A four-month program imparts certifiable skills training to men in welding, electrical works, carpentry, auto mechanics, auto electrician, motor cycle mechanic, plumbing and masonry. Women participate in handicraft and dress designing trades in affiliation with Skill Development Council Peshawar. Upon course completion, graduates received a tool kit designed for their respective trades, which enabled them to establish small scale businesses or more easily find employment in Pakistan or Afghanistan.

Duration Jul 01, 2014Jun 30, 2015
Location UCs Ichrian, Khaki, and Mansehra, Mansehra District, Khyber Pakhtunkhwa, Pakistan
Key Activities
  • Provide accessible preventive and curative health services to women and children from refugees/host community in Ichrian and Khaki camps
  • Provision of RH (reproductive health) services to the women of Child bearing age
  • Enhance the capacity of male and female health workers (M/FHWs) and the Community Health Committees
  • Transition of health services to Government Health Department, Mansehra and enhance their capacity to cope with the refugee caseload in the future
Participants 52,200 Afghan refugees
12,800 Host community members

Phase Phase OnePhase Two
Duration Sep 07, 2014Sep 06, 2015
Location Mansehra and Haripur Districts (Afghan Refugees Camps and surrounding host community)
Key Activities
  • Provide vocational skills to 216 Afghan refugees (144 men and 72 women) and 144 Pakistanis (96 men and 48 women) from the host community to earn dignified livelihood through vocational training.
  • Trades included in the vocational training program are: tailoring, motorcycle repairing, electrical work, and welding for men and dress designing/tailoring and handicraft for women.
  • Secure employment for and increase household income of 513 previously-trained and 360 newly trained graduates.
Participants 360 (240 male and 120 Female) Training participants
270 Previous male graduates: Marketing/linkages:
370 (100 women and 270 men): Refresher/advance training:
216 (100 women & 116 men): Employment/linkages of newly trained graduates
240 Women: Enterprise development training
20 (10 men and 10 women): Small medium enterprises
100 Graduates (men): Linkages/employment in Afghanistan
30 Graduates (women): Exhibition

Phase Phase OnePhase Two
Duration Jul 01, 2010
Location Mansehra and Haripur, Khyber Pakhtunkhwa Province, Pakistan
Key Activities
  • Skills training in auto mechanics, carpentry, electrical works, masonry, plumbing, welding, dress designing and handicrafts
  • Training on market behavior
  • Career counselling
  • Curriculum vitae (CV) writing skills
Participants 1,005 male Afghan refugees and members of host communities
510 female Afghan refugees and members of host communities

I now play an important role in my family’s livelihood. We spend most of this money on nutritional needs and also health and clothing needs…I will invest some of the net profit in order to make my business more stable and productive.

Majid Khan, vocational training participant who opened his own business

Duration Jul 01, 2013Jun 30, 2014
Location Mansehra, Khyber Pakhtunkhwa Province
Key Activities
  • Consultations by qualified doctors and lady health visitors (LHV)
  • Provision of essential drugs
  • Reproductive Health care services with a special focus on Mother and Child health including Ante-Natal and Post-Natal care
  • Health Education sessions focusing on water borne diseases, STIs, HIV/AIDs, locally relevant diseases and distribution of information materials
  • Referral of patients to Secondary and Tertiary healthcare facilities
  • Management of alerts, threats and outbreaks, if any, in collaboration with MOH/WHO
  • DEWS reporting
  • Expanded program on immunization against childhood preventable diseases
Participants 60,000 Afghan refugees

When I was a child, I received vaccinations from CWS-P/A’s basic health unit and visited the BHU when I was sick. It was my dream to become a doctor and help my community. I really liked the vaccination and awareness programs, which is why I wanted to work and am still here eleven years later as a medical officer.

Dr. Wali Jan, a doctor with Community World Service Asia’s health program

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