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Middle-aged Krishen Kohli lives in the hamlet of Hanif Khanzada, ten kilometres from Tando Jan Mohammad in Mirpur Khas district. He is a landless farmer who works as a labourer for a local landowner. He has six daughters and a son. Their son came at number four. “We wanted a few more sons so we kept at it and all God gave us was another three daughters,” he says with a chuckle.

He owns no property; even the home he lives in is built on the landlord’s land and he makes a very meagre living from his work which is irregular. Krishen believes that a child sent into the world is by the will of God and so it is His job to provide them food. Even if that food is only chilli paste and millet bread? “Yes. The child is fated to have only that much.” Krishen’s faith in kismet is as firm as that of anyone who is very poor and has no control over circumstances. In any case, he knows of no family where the man and wife have lived together for fifteen years or more and have fewer than ten children. As for himself, he says he has had enough. He does not want any more children.

Amidst the flood crisis, Kirshan’s residence suffered extensive damage as a result of the flood. In response, he undertook the task of constructing a new dwelling using locally available materials such as wood and mud. Additionally, Kirshan faced health challenges, prompting him to seek medical assistance from the Mobile Health Unit (MHU) of Community World Service Asia due to the inaccessibility of conventional hospitals. The MHU played a pivotal role in providing relief during these difficult circumstances.

Community World Service Asia’s (CWSA) Mobile Health Unit (MHU) supported by Catholic Agency for Overseas Development (CAFOD) and Disasters Emergency Committee (DEC) was on a follow up visit after the first round. On both occasions Krishen had attended the health awareness session delivered by the CWSA social mobiliser and agrees that he and his wife should have had fewer children.

He was very pleased with the health camp. For the past about seven years, he has had ‘heat in the stomach’, the usual local term for acidity, and constipation but he did not go to the government hospital at Tando Jan Mohammad. Instead, he consulted a private doctor whose fee was PKR 500 (Approx. USD 1.7) and to fill his prescription Krishen parted with PKR 1300 (Approx. USD 4.5). Adding to that the to and fro fare, the cost of the visit went up to PKR 2500 (Approx. USD 8.8). That was beyond the capacity of a poor landless peasant and most of it was taken on loan from the landlord to be adjusted against Krishen’s wages. “The medication lasted me three months and when the course was done, I remained well for another five or six months,” reports the man.

Dismissive of the government facility in Tando Jan Mohammad, Krishen says their free medication never works. Fifteen days earlier, on the first visit of the mobile health unit, he was given five pills, one for a day. And he had never felt better. This was such effective medication, he says, that it has improved his appetite as well. Now he was back for it. The health project had been extended on this very day and the facility was available to the village for more time. If Krishen were to visit the medical practitioner in town in 2023, he estimates he would be set back by about PKR 5000 (Approx. USD 17.6).

Gauri, another fellow resident of Tando Jam, is pregnant with her seventh child and she is not even thirty years old yet. She too has attended the health sessions and heard all about family spacing and that a small family is better fed than a large brood. Like Krishen, she too is not really convinced about a small family being ideal. One can hardly expect that when you live in a social and cultural eco-system that favours huge families.

The first two of Gauri’s babies were delivered by her mother, an experienced midwife. But then she was too old and did not wish to endanger the third child so Gauri went to the government hospital at Tando Jan Mohammad. “The doctor shouted at me, telling me to get back and wait outside. We are poor people and that is how they attend to us,” she complains. She sighs about the expense of coming and going and then being treated badly by the medical staff. After the first visit, she gave up and consulted a private maternity clinic that delivered her next two babies. Each visit delivery cost her PKR 20,000 (Approx. 70).

That put her husband under a huge debt to the landlord and it took a couple of years to repay. In which time Gauri had two more children who were delivered by an inexperienced midwife from a neighbouring settlement. And in September 2023, she was pregnant for the seventh time with plenty of child-bearing years ahead of her!

As useful as it is to treat recurrent scabies and respiratory tract infections – the most common complaints in the area – it is necessary to intensify health sessions on sexual and reproductive health of women and young girls in such areas. There needs to be greater emphasis on post-partum care and nutrition of families, women and children alike. Through this project, community mobilisers and health practitioners have engaged with communities on raising awareness and initiating dialogue on these needs but the focus has largely been on providing immediate health care to flood affected communities suffering from diseases and illnesses or needing maternal and neonatal care. There is definitely space to do more.

Meanwhile, the seventy odd women and men waiting in the shade of the trees outside the mobile health unit were happy that they were getting medication that worked. And it was totally free of cost. For women like Gauri who had only a few minutes earlier shrilly complained that government doctors did not even listen to her and others like her, the medical officer in the health facility was an angel.

Sindh Province in Pakistan has seen a wave of climate-induced disasters and other crises in recent years. Drought, Locust Attacks, the COVID-19 Pandemic, and Flooding, have all left district Umerkot and Sindh’s desert region particularly hard hit. Umerkot in particular is historically prone to moderate droughts and is categorised as highly vulnerable according to the Drought Vulnerability Index. With the support of Australian partners, Community World Service Asia is working to provide essential health and quality education services to communities affected by climate-related issues and displacement in Umerkot.

A survivor story

The floods in 2022 left millions of people in Pakistan displaced. Under the ACT Appeal, Community World Service Asia reached out to more than 7000 flood affected people (1099 households) by providing cash assistance to purchase food and essential household supplies. A total of PKR 60,000 (Approx. USD 203.3) was distributed in three separate tranches; in May, June, and July, with affected families receiving PKR 20,000 (Approx. USD 67.3) per month. This monetary support help meet their immediate food needs while also enabling them to save for other essentials, such as medical expenses, clothing, and more.

Hamzu Veerji, a 43-year-old mother of three children from Mir Deen Talpur village in Mirpurkhas district, was one among those supported through life-saving initiatives under this appeal. Hamzu and her husband, Veerji, have been married for fourteen years and have been pillars of unwavering support to each other. They worked together on agricultural fields of a local landlord as a means of livelihood before the flood struck their village. They cultivated and harvested red chillies on one acre of land and received a merger wage between PKR 150 to 200 (Approx. USD 0.51 to 0.68) per day.

Like many others from Mir Deen Talpur, Hamzu and her family was forced to abandon their home and belongings in haste, taking only basic food items (that would barely last them a couple of meals) and their two livestock—a bull and a goat, along with them. With not much money at hand nor a source of running income, the family had to sell their prized bull for a mere PKR 15,000 (Approx. USD 52). “Our bull was very precious to us and had been one of our key source of sustenance for years. We had no choice but to sell it. And that too at a very low price.” Hamzu and Veerji had purchased the bull in 2015 from a fellow villager for PKR 4000 (Approx. USD 14) as an investment to increase their livelihoods, as income from agricultural work was insufficient to provide for their children.

Without their cow and their daily wage, the family lived in a temporary shelter without proper protection on an elevated open ground for two months while waiting for the floodwater in their village to recede. Their village had accumulated up to five feet of water. When Hamzu and family returned to their village, it took them another two months to rebuild their mud-house; that meant more time under the open sky without a structured shelter or a roof to keep them safe. The family of five all lived and slept on just one charpai (a traditional woven bed used across South Asia). The charpai was among the few items they owned that had not washed away in the floods.

Hamzu and Veerji could not bear to see their children suffer these post-flood hardships anymore. But they felt helpless. Building their house again required a lot of time, strength and resources. All they were short on. “Initially, it began with the rain, followed by the challenge of enduring without food and shelter. Later, the heart-wrenching sight of our house reduced to a mere fragment clinging to life greeted us upon our return. Our children were profoundly affected, having already endured a great deal. My husband, Veerji, and I had to act swiftly to reconstruct our home, but the process of mixing water and mud was time-consuming, and allowing the structure to dry also required patience. Nonetheless, we made every effort to expedite the process,” shared Hamzu.

Access to clean water has always been a scarcity in Mirpurkhas. And the floods further exacerbated this issue. This meant increasing health problems among affected communities in villages like Mir Deen. The nearest well to fetch water from is at a six kilometres walk from Hamzu’s village and unfortunately this water is not even clean. This was a major challenge and concern for Hamzu and Veerji who really just wanted to ensure the good health and safety of their children. Luckily, with financial support from Community World Service Asia (CWSA) they were able to purchase clean drinking water and some groceries to stock up.

From the first instalment of PKR20,000 received, they spent ninety percent of it (Approx. USD 62) on groceries and drinking water and saved the remainder for future needs. “We used the money to buy sugar, tea leaves, rice, vegetables, and a few gallons of water, as the water we collected from the field was undrinkable. We could only use that to prepare the mud for our house.”

Hamzu prioritised purchasing abundant food for her family to protect her children from the risk of malnutrition, a serious concern in rural Sindh, especially among children in their formative years. Her youngest child, Meher, who is just 4 years old, had lost a lot of weight due to the lack of proper nutrition after the floods.  Hamzu was now relieved that her children could consume nutritious meals and regain their ailing health.

The couple utilised the second instalment then for purchasing another goat (PKR 5000), to buy clean clothes (PKR 5000) for their children and the remaining on restocking food items. Hamzu explained their approach to managing the aid, stating, “With each instalment, we bought groceries and saved between PKR 2000 to 3000 for future needs, as we knew this assistance was not permanent. I discussed with Veerji the importance of saving money so that we can buy another bull, as it is the only way we can foresee now to improve our economic situation.”

Following the floods, Hamzu and Veerji found themselves without work and income but now they own two goats that provide milk, which they sell to fellow villagers. They have saved a total of PKR9000 (Approx. USD 30.5) up until now from the cash support provided to them. Hopefully in a few more months this hard-working couple will be able to buy a bull which will enable them to expand their income by selling its milk in the market.

Despite the hardships, Hamzu and Veerji value maintaining stability in their life for their children. With the support provided under the ACT appeal, they were able to rebuild their life step by step, with dignity and respect. Through careful budgeting and prioritising their family’s well-being, Hamzu and Veerji not only overcame their flood-imposed suffering but also created opportunities for a brighter future for their family.

In a quaint little village named Birkhio in Umerkot, a woman named Pohno experienced loss and suffering as her cherished goats, a primary source of livelihood for her, fell prey to skin diseases and infections. The devastating floods in 2022 had not only damaged lands and taken lives in the area but had also led to a spread of infectious diseases among people and livestock both.

Sadly, Pohno’s animals were among the many thousands who had succumbed to the post-flood epidemic. As a widow and single mother of three adult children, all of whom had their own responsibilities now, Pohno found herself in a challenging situation – without any means of income.

“My primary source of livelihood revolved around the livestock we possessed. But my world was swept away along with the floods that struck Birkhio last year. The floodwaters contaminated our surroundings, leaving our goats exposed to a range of harmful pathogens. The skin diseases and infections ultimately led to the demise of most of my livestock,” lamented Pohno. She had heavily relied on her goats for sustenance and income, and their loss had left her devastated. Pohno owned a total of 35 goats, 20 of which perished due to underlying issues. The primary problem leading to their demise was the insufficient supply of proper nutrition to their bodies. The remaining 15 goats were only able to survive because Pohno started providing them with extra care.

To support households and individuals affected by the economic and social impact of the floods, Community World Service Asia and its long-term partners, Diakonie Katastrophenhilfe (DKH) initiated a humanitarian project to provide essential relief resources that would be sustainable but also income-generating.

As a participant of the project, Pohno received animal food and health kits that were designed to retain and improve the health of her remaining goats. These kits included medicines, vitamins, and hygiene products specifically tailored to increase the well-being of local livestock. Pohno also received Hydroponic seeds, which helped her produce a more nutritious diet for her livestock. “The use of Hydroponic seeds has been something new and very innovative for us. It is a novel approach that has incorporated specific leaves into the goats’ diet, enhancing their overall health and improving their skin conditions.”

During dry seasons in Umerkot, there is a huge scarcity of nutritious fodder for livestock, leaving them with little to consume apart from dry leaves, making them weak and leaving them hungry. Hydroponic, on the other hand, is a type of fodder that takes approximately ten days to grow and is then fed to the goats. It involves mixing Hydroponic grass with dry grass to provide the goats with enhanced nutrition. This proved to be a pivotal factor in significantly improving the health of Pohno’s goats. “Incorporating these leaves into the goats’ diet had a profound impact. It provided the goats with a valuable infusion of essential nutrients and antioxidants, strengthening their immune systems and equipping them to combat infections effectively. The combination of this improved diet, along with the medication and hygiene measures supplied in the health kits, resulted in a remarkable transformation in the overall health and well-being of the goats.”

Pohno was among sixteen individuals who received training under the project to strengthen the livelihoods and resilience of communities that lived below poverty and those that were most vulnerable to climate change impact. This training became instrumental in familiarising participants with the use of hydroponic seeds and their advantages for livestock survival. It also helped communities learn about proper feeding practices and timings necessary for improving the health of their livestock.

As the health of Pohno’s goats improved, they began to produce better-quality milk. This not only benefited Pohno’s own household (where she takes care of her ailing daughter) but also served as an additional source of income for her. The recovery of her goats instilled a renewed sense of hope and strength in Pohno’s life, empowering her to regain control over her livelihood.

Community World Service Asia is a non-governmental organization, which implements humanitarian and development activities in Pakistan. We have been effectively implementing development projects in KPK, Punjab, and Sindh. Community World Service Asia is registered under the Societies Act of 1860, bearing Registration No. KAR 0072 as a local NGO recognized by the Government of Pakistan. Our headquarters are located in Karachi, with liaison offices in Islamabad, Lahore, and Umarkot. Additionally, we have signed a Memorandum of Understanding (MOU) with the Ministry of Economic Affairs Division (EAD) in Islamabad, under the Government of Pakistan.

Community World Service Asia is inviting sealed quotations for the construction of 15 solar powered water points at UC Faqeer Abdullah and Kejarari, Umerkot. The Bill of Quantities (BoQ) documents can be found within the documents as Annexure – A.

The deadline for the submission of sealed bids or through email cwsasia.rfq@gmail.com is Sunday, November 5, 2023, by 15:00 hrs.

Download tender documents

Kitchen Gardens: A sustainable model for food security & diversity for the people of Umerkot

“We, none of us in this village, ever thought of keeping a kitchen garden. It was something beyond our thinking,” with these words Sohdi of village Charihar Bheel echoes the voice of thousands of women and men across the desert area of Umerkot. This is what they believed until Community World Service Asia (CWSA) launched the training sessions on kitchen gardening.

Now, even though they live in a sand desert, the communities of Umerkot are all farmers and livestock keepers. Their practice has long been to plough their fields in late June and sow the seeds of their seasonal crops in anticipation of the coming monsoon. For vegetables, however, they made a separate set of furrows on one side of the main field. Because the fields are outside the village, sometimes a little way off too, there was no way of watering them. Therefore, while hardy crops like guar beans, mong or millets could survive until the rains begin in July, the vegetable seeds needed watering.

Consequently, the seeds that made it through until the first shower produced a small crop of vegetables to last a few days. If the rains were good, the farmer’s family had a supply of wholesome, organic vegetables for a few weeks. And then the plants withered. That is, a farming family in Umerkot had vegetables only once a year during the first fall of summer rains. Of course there is the hardy chibhar (Cucumis melo agrestis), wild and abundant in the summer whose miniature melon-like fruit can either be stewed fresh or dried. There is also the kandi (Prosopis cinerara) tree with its leguminous seed pods that make another nourishing stew known as singri. And then, during the monsoon, the people of Umerkot have the luxury of a fine and rather abundant mushroom, even if for a short while.

This, then, is the limit of their fresh local vegetables. The other source is purchasing from the city. This is done only when someone is in town for work; to go especially for vegetables would make the purchase unaffordable. Since there is no way to stock them fresh at home, the purchase is usually for two or three days and consumed in this period before the vegetables go off. Unsurprisingly, the usual diet in Umerkot was wheat or millet flatbread with chilli paste washed down with water. Variety in diet was virtually unknown for the most part of the year.

Yet, as Sohdi says, no one ever thought of preparing a patch nearer to their home to have a regular supply of fresh vegetables.

The kitchen gardening intervention, by Community World Service Asia, Canadian Foodgrains Bank (CFGB) and Presbyterian World Service & Development (PWS&D), with relief following the drought of 2021 introduced the farmers of Umerkot to the idea nobody had thought of before: a small patch right by the house for vegetables. This is always in the charge of the woman of the household and speaking with several of them one can learn how to manage a kitchen garden for fresh vegetables: water the patch and keep it moist for three days before adding animal manure. Then prepare the furrows and plant the seeds. Flood irrigation is a wasteful idea of the past; watering should be done with a used PET1 cola bottle with its cap punctured to deliver a small stream in the root of the sprouting plant. And the kitchen garden is ready to supply vegetables two to three weeks after the sowing.

An hour distance away, in New Subani, the very vocal Dai who is a member of every committee in the village, has no doubt how well her kitchen garden serves her family. She says she planted her first patch in March 2022 with okra, chibhar, guar, cucumber, squash and zucchini. It was very fruitful and she has never looked back since. The garden sowed in March lasted until the middle of May before withering away in the arid pre-monsoon heat. “Everyday we had vegetables with our chapatti which beats chilli paste any time. And my crops of squash, okra and zucchini were so abundant, I gave away vegetables gratis to my neighbours,” she says.

According to Dai, the fear of what to feed a visitor was banished from her life after she began her kitchen garden. That year, Dai did her second batch in July. The rains were very good and her garden lasted well into August. She kept the seeds from her vegetables and with some supplied by CWSA, planted a very successful kitchen garden again in March 2023. In July, she yet again had a little garden coming along well after the first rain of the season.

Earlier, every year Dai planted a small patch of vegetables by the side of her agricultural plot. It was always a dicey business. To get some little out of it was considered good fortune, and that only when it rained on time. But the CWSA training on kitchen gardening and this idea of having the patch next to her home has made her a supplier of free vegetables to her neighbours and anyone who comes asking.

Far away in Kachbe Jo Tar, another village in the same district, school teacher Bhammar Lal Bheel tends his wife’s kitchen garden. He speaks of the joy of having fresh spinach, okra, eggplant, marrow and pumpkin and says that the variety of the menu in his home has given him more energy than he ever had. “The millet chapati (unleavened flatbread) slides down very easily when taken with a vegetable stew,” he says with a smile.

Being the man who goes frequently into town, he knows the rate of vegetables and recounts it for the listener. Two days’ worth of greens for a family of eight members like his put one back by at least PKR 800 (Approx. USD 2.75). And even then the vegetables were not very fresh. He also knows that they are treated with harmful chemical pesticides. But now with their own kitchen garden the family has fresh, straight off the stalk vegetables that are one hundred percent organic too. It is free because CWSA provided his wife the seed to augment her stock she saves from her previous garden.

Bhammar Lal produced a MUAC (Mid Upper Arm Circumference) measuring tape. He says he first of all began by measuring MUAC in his own family and was surprised by the progressive increase in size among the children in the weeks following the addition of vegetables to their diet. Then he went around the village comparing the measurements of those families with kitchen gardens with those who did not have them. “There was such a clear difference, not only in children’s MUAC, but of grown women as well. That speeded up my personal campaign to encourage more and more kitchen gardens,” he says with visible pride. “It’s the vitamins!”

Bhammar Lal says his wife participated in the CWSA training sessions and learned how to make the best of the little vegetable garden. But there are women who were not part of the training and who are not in on this little open secret. “I go around the village instructing other women on how to make a kitchen garden. And then I follow up a few days later and if they are not at it, I encourage them to at least try it out,” he says. He is happy that by his effort, there are many more kitchen gardens in the village. To paraphrase Sohdi again: everyone is happy because chapati goes down so well with stewed vegetables.

Not too far, in Rohiraro village, the ever-smiling Gauri points out one effect of the kitchen gardens that have now sprouted almost all over the village. And this may not have been foreseen by the NGO: with the vegetable patch to look after, women have not gone to ‘Sindh’ (as they refer to the irrigated districts to the west) last year and again in 2023. In consequence, children who leave school in March to travel with the family and return after the summer vacations have had two full years of education.

In Gauri’s view, the real winner is education. That is even more important than just good health.


  1. Polyethylene Terephthalate

Village Dharshi Bhagat lies by the road connecting Samaro town with Samaro Road; the latter being the town’s railhead where the old abandoned metre-gauge railway station still stands for the first two weeks after it started in late July, the rain did not stop for a minute. Thereafter it continued to teem down with brief intervals lasting never more than some minutes until the village went under a metre of water.

Twenty-five-year-old Heeru was only days from delivering her baby when it started. As the water rose, she and some other women made a desperate run to save whatever little cotton they could from the fast drowning field they had so carefully tended the land they worked as labourers. The struggle in mud and water was worth only a few thousand rupees.

With the village going under water, she and her family left their home and the fields and moved to the only stretch of road that was above the dark water. For three months, they lived under a makeshift shelter of bamboo poles holding up plastic sheeting for a roof. It was good fortune that Heeru had salvaged some cotton and there was some cash for food because in the time of the rising waters, she gave birth to her second child, a daughter. When her pains began, her husband hired a motorcycle and ferried Heeru to the Basic Health Unit at Samaro Road where she fortunately got the attention of the doctor and a safe delivery.

Not long after the birth of the child the meagre cash in her kitty ran out and her family subsisted on chilli paste and roti. Their one goat provided a small amount of milk daily. It was a hard life for the family, especially so for the young lactating mother.

Heeru recounted how her firstborn, a son, had died two years ago aged just four months. The child had gone down with fever and convulsions and though the Basic Health Unit at Samaro Road was just 4 km away, the parents were tardy in taking him there. For five days the poor child suffered and when they eventually did get to the BHU, the doctor could do nothing to save the baby.

For some inexplicable reason, seeking medical assistance was simply not a priority for these poor people. They still relied on folk medicine and even considered milk tea some sort of panacea.

Dharshi Bhagat, who gives his name to the village, said Heeru’s husband was lucky to be able to rent a motorcycle because shortly after, the only transport capable of plying on the submerged roads were big four-wheel drive vehicles. An ailing person had to be carried either on a string bed or piggyback all the way to the units either in Samaro or Samaro Road. And this was a time of rampant disease. Fever, skin infections and diarrhoea were raging in the makeshift camp strung out along the road. In that desperate time of zero income, men were seen carrying the ailing to the BHU.

In mid-October, the first Community World Service Asia’s medical mobile unit reached this village. The village was still submerged and the mobile unit had to be parked on the road, the only strip of land free of water. Dharshi Bhagat said this came not a day too soon for who would not have appreciated this gratis service at the doorstep in that time of great adversity.

Lady Health Visitor Farkhanda said the mobile unit had been on the road for ten weeks moving from village to village and treated on average a hundred and fifty patients every day. On the first visit to Dharshi Bhagat, they had a similar number between nine in the morning and three in the afternoon. Referrals of more complicated cases was made to the Samaro town hospital. Common complaints were malaria, water-borne gastro-intestinal, eye and skin infections. This time around, respiratory tract infections had increased and the demand was for ‘pills for strength’, as multivitamin tablets are referred to.

Outside, among the crowd of men waiting to consult the doctor Bhoomo said he felt weak and his ‘liver burned’ and showed a handful of blister-packed multivitamin tablets and an antacid.

“The first time the medical van visited our village, I was suffering from the same, but I had been out cutting mesquite to sell in neighbouring villages and I missed my chance to see the doctor,” said Bhoomo. For him his suffering was secondary. Most essential was for him to make some little cash for food.

Why hadn’t Bhoomo gone to the hospital in town during all this time? “I have no money, the fare out and back is Rs 40, and after I spend a day cutting mesquite, there is only enough cash to purchase food for my family of nine. I cannot afford to go to town.”

On the second visit in mid-November the mobile health unit had in just two hours treated one hundred and thirty patients. And an equal number waited patiently outside. Some like Dheero said they had no complaint and had come only to watch the goings on; most others complained of stomach ache and fever. Nearly all of them had either simply suffered stoically or experimented with folk medication to no effect. The lament was the same all around: they had no money to visit the hospital in town. And they could not afford to take time off from their struggle to earn some money.

Listening to the very vocal Kasturi, suffering in silence seemed to come naturally to them. She had a reasonable income from working as a seamstress while her husband was a door-to-door clothier. Their once comfortable life was now reduced straitened circumstances.

“The crops have all been destroyed. There is no work and therefore no money. Who can order new clothing in these times? The Lord is kind, I took great precautions and my three children did not fall ill, but families with illness could either feed themselves one, or at most two, meals a day. They did not have the means to make frequent trips to the Samaro hospital.”

Dharshi Bhagat was right: the mobile unit had come not a day too soon.