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The Community-based Management of Acute Malnutrition (CMAM) Surge Approach is designed to enable health systems to effectively treat children diagnosed with acute malnutrition. The CMAM approach relies on the assumption that the number of children with acute malnutrition increases drastically at certain times of the year in many places. Low birth weight owing to poor maternal nutrition, protein-energy malnutrition, anaemia, and iodine deficiency are all major nutritional issues in Pakistan. Since 2013, Pakistan has been a part of the worldwide Scaling Up Nutrition (SUN) effort to address these nutritional issues. Sindh is severely affected by intensifying malnutrition and stunting indicators. As many as 48 percent children under the age of five are stunted while 35pc of them are severely stunted[1].

Aware of the rising rates of acute malnutrition among remote and impoverished communities of rural Sindh, the People’s Primary Healthcare Initiative (PPHI)[2] of Sindh, in collaboration with Community World Service Asia, conducted orientation sessions on CMAM Surge Approach for community-level implementation for early diagnosis and referral of malnourished children in Umerkot district of Sindh.

In June, awareness and orientation sessions on CMAM Surge approach were held in two villages of Umerkot where forty members (both men and women) of village level Health Management Committees (HMC) participated

The sessions focused on the CMAM Surge Model that seeks to improve the resilience of health systems to be able to deliver more efficient and effective medical and preventive treatment for acute malnutrition over time. The focus was on providing the best care during times when cases are at a peak and the need for health services to address these cases is the highest. The potential to save maximum lives is at its greatest then, while ensuring that the capacity and accountability of the public health sector is not undermined.

The CMAM Surge applies an eight step approach to assist health teams in responding to rapid changes in capacity and caseloads. The scaling up of CMAM Surge has resulted in additional learning and adjustments to the methodology that are context-specific. The sessions were facilitated by PPHI and along with thorough learning on the CMAM, nutritional plans, relevant reading material, referral slips and brochures were shared with participants.

In the last six months, 45 cases of malnutrition have been recorded at the MNCHs of Samaro and Pithoro as a result of insufficient food and an absence of a balanced diet. Participants learned about the prevalence of malnutrition and its causes, particularly among children. During the sessions, participants were made aware of the many different forms of malnutrition and how to prevent it. The importance of breastfeeding and consuming a well-balanced diet were stressed upon with participants. A practical exercise was also conducted where participants learned how to measure lactating and pregnant women and children using the Mid-upper Arm Circumference (MUAC) tape.

Learnings of HMC Members:

“I knew very little about malnutrition and the services provided by PPHI to alleviate malnutrition in Sindh. We learned a lot about identifying cases of malnutrition and when and how to refer them to doctors. I will now be able to check children for malnutrition and, if necessary, refer them to the nearest PPHI centre. I also learned that malnutrition is not a disease, but rather a result of human negligence, poverty, unsanitary conditions, and food insecurity. I will sensitise people in my community to maintain hygiene at home and their neighbourhood and provide a healthy diet to their children to avoid malnutrition.”

Chetan Kumar, member of Health Management Committee in Samaro

“The CMAM Surge Model approach is a great way to assist health systems offer treatments to children with acute malnutrition more effectively. Members of the HMC will be able to predict when seasonal caseload surges are likely to occur and will use this information to better prepare themselves for management of services during times of high demand. We were able to gain a thorough understanding of malnutrition, its causes, and how to prevent it. We are now better equipped to refer malnourished children to the nearest PPHI centre for treatment.”

Nabi Bux Solangi, member of Health Management Committee in Samaro

“We discovered that the MUAC is utilised to determine nutritional status of women and children. Because it is simple and inexpensive to use, we can efficiently apply it for active case finding. MUAC is an effective indicator of mortality risk associated with malnutrition, it is therefore a better measure to identify children most in need of treatment. The use of MUAC tape will allow me to immediately refer children with acute malnutrition to doctors in a timely manner.”

Lachmi, member of Health Management Committee in Samaro

“It was my first nutrition training session, and it was a great learning experience. Malnutrition awareness is critical in our community, and individuals must understand how to prevent it. The knowledge on malnutrition, its prevention, and the usage of MUAC tape will help in the mitigation of malnutrition in our village, Mirashah.”

Shanti, member of Health Management Committee in Pithoro

“We were not aware of PPHI’s nutrition program being operated in our vicinity. This session improved our knowledge of malnutrition and its many forms, as well as the use of MUAC tape and the referral of suspicious cases to the PPHI health centre for treatment.”

Sisliya, member of Health Management Committee in Pithoro


[1] https://www.dawn.com/news/1426604

[2] Footnote: PPHI Sindh is a not-for-profit company setup under section 42 of The Companies Act 2017. PPHI Sindh has focused on mother and child health and has continuously improved delivery coverage all over Sindh.

Sodho is the President of the Village Management Committee and Disaster Risk Reduction (DRR) Committee of Male Jo Par Village in Umerkot, Pakistan. He has actively been working to promote sustainable farming practices and build community awareness on DRR to enhance community resilience on recurrent hazards and climate change impacts. The Village Management and the DRR Committees[1] were established in September 2020 under Community World Service Asia’s emergency response project[2], supported by the Ministry of Foreign Affairs, Japan.

“I have coordinated and helped the project team conduct 19 trainings focused on kitchen gardening, fuel efficient stoves, sustainable agricultural practices and DRR since last year. It is a relief to see that our people have the knowledge and skills to protect themselves from natural hazards.”

On September 24th, 2020, an orientation for VMC members was organised to share project objectives and to familiarise members with the role of the committee and as individual members.

“All 15 members, seven women and eight men, were explained their responsibilities as VMC members. We were taught on how and when to coordinate with the project team and how we can contribute in organising project activities. By the end of the training I was also elected as the President of the committee.” 

Sodho, along with fifteen other community members, participated in a training on DRR held in October 2020. All training participants shared and learned about common natural and man-made hazards such as earthquakes, floods and fire, experienced in the region.

“The knowledge on DRR was new to the community members. They now know of and are well aware of the different disasters that their people are faced with and have identified ways of alleviating and lessening its effects. Through the training, communities were provided technical knowledge on all kinds of hazards, developing disaster prevention plans and the importance and methods of raising community awareness on DRR.”

Sodho shared a recent accident where a fire broke out at a house in a nearby village. The family was saved but they suffered a massive loss as all their essential belongings and household items were burnt.

“As an active member of the VMC, I immediately called for a meeting to discuss how we can collect donations and help the family recover from the loss. We were able to collect some clothes, food items and essential household items for the family. Through the immediate help, the family found some relief and were hopeful to recover from the monetary and infrastructural loss sooner.”

“VMC members also organised a lesson learning session for their local communities on what they had learned at the DRR training to further enhance community knowledge and capacity on preparedness and mitigation. To overcome natural and man-made disasters, the participants were told about the different disasters and how to minimize the destruction they bring to affected areas. We also shared the story of the house-fire as an example and conducted drills to show what items to save first in the case of a fire and how to prevent the damage caused by such disasters.”

Kitchen gardening, primarily engaging women in the target villages, is another key component of the project. Sodho was personally quite interested in this initiative as having an opportunity to grow healthy vegetables at home seemed like a blessing and was a new concept introduced in the village.

“I saw the benefits of kitchen gardening immediately when the team shared the concept. Growing healthy vegetables at home can bring good health to families and save money as well which was otherwise mostly consumed on purchasing vegetables from the market.”

“I encouraged all women in the village including my own wife to participate in the kitchen gardening trainings. In the last winter season, my wife grew white radish, carrots, spinach, lady fingers and pumpkin in her new kitchen garden. I could see how much she enjoyed working and bringing seeds of different vegetables and fruits from the market to grow in her garden. She is now growing watermelon, guar[3], pumpkins, bottle gourd and lady fingers.”

Sodho further added that their village, Male Jo Par, has existed for the past hundred years and in these many years no-one had ever thought of starting kitchen gardening.

“We reside in the remote areas of Umerkot. The agriculture fields are faced by severe water scarcity. The land has low productivity due to unfertile soil and lack of water. We never thought of growing vegetables in our homes so conveniently with the help of home-made fertilisers and compost. Today, families in Male Jo Par grow garden-fresh vegetables on a daily basis, improving the quality and quantity of their food consumption, nutrition and well-being.”

Sodho also participated in a training session focused on sustainable agricultural practices for farmers, conducted in December 2020 under the project. Ten other small-scale farmers took part in this training.

“Before we took the training, all of us farmers stocked all seeds together in plastic containers and could not differentiate good ones from the bad ones. We would plough the land and sow all the seeds. Consequently, not all crops would grow well. The money that we spent ploughing and harvesting the land would be wasted as the produce would not be as fruitful as expected. This year was different. We stocked the seeds in Stoneware Pots (Matka) and before sowing them, we dried the seeds for at least three days under the sun. As a result, we had a good harvest this year.”

Our village has seen a positive change since the initiation of the DRR project. There has always been severe water scarcity in our area. The RO plant[4], which is being constructed in our village, will also help our people and those of surrounding villages to a great extent. It will provide clean drinking water at a walking distance. Our wives and daughters will not have to travel far places to collect water.”


[1] These are community based structures, members consisting of community people, who are responsible to coordinate project activities and awareness building. They are the key for sustainability and viability of project activities and mobilization of available local resource.

[2] Enhancing disaster resilience against droughts in Sindh Province

[3] Guar is an important legume crop. It is cultivated for fodder as well as for grain purpose.

[4] A reverse osmosis plant is a manufacturing plant where the process of reverse osmosis takes place. Reverse osmosis is a common process to purify or desalinate contaminated water by forcing water through a membrane.

Living with her seven children, Shaibaan is constantly multi-tasking to meet the everyday needs of her family. The children demand attention and unconditional care.

“All day long I am busy taking care of the children, engage in household chores and in cooking meals. My husband, Karshan, is a labourer, earning a monthly income of PKR 7500 (Approx. USD 46). My five younger children go to school but my two elder son and daughter don’t because we cannot afford to pay the fees of all seven.”

Shaibaan and her family live in the remote village of Ratan Bheel in Umerkot district of Sindh. Though many households depend on local vegetation in the area, Shaibaan never thought about growing a kitchen garden in her front yard.

“I had no experience of growing crops before and it was not very common to grow crops at home. We purchased vegetables to cook. When we did not have money to buy vegetables or any other food item, we ate red chilies with rotiⁱ,” said Shaibaan.

Selected alongside thirty other women from Ratan Bheel and nearby villages, Shaibaan was trained on kitchen gardening techniques in March 2019. The group of women were familiarised on the concept of kitchen gardening and how it improves food security of households. They were taught different vegetable sowing and pest control techniques. Shaibaan and other participants were also trained on how to conduct seed germination tests which would help them save time, energy and resources when cultivating difficult to grow seeds. Germinationⁱⁱ tests measure the resilience of seeds, thus allowing farmers the option to decide on how many to plant or whether to plant at all.

Shaibaan replicated the training in fourteen other households in her village.

“I did not think of growing a kitchen garden in this desert area. When Shaibaan came to my house with this initiative, I was amazed to know how we can grow clean and healthy vegetables in our yards for our daily consumption when cooking food. We now have the pleasure of eating homemade nutritious vegetables of various kinds. The garden in the kitchen is now a means of food diversification and food conservation for us,” said Saleemat, another Ratan Bheel kitchen gardener.

“Today, my family supports in maintaining the kitchen garden with me. My two elder children take keen interest in taking care of the garden and growing new vegetables and plants in it. It has been a year now since we have been growing vegetables in our green garden. We are now growing cluster bean, lady finger, ridge gourd and brinjal. Moreover, we are also able to save PKR 500 (Approx. USD 3) every week, which we previously consumed in purchasing vegetables from the market. We use the money we are saving to buy other household essentials such as linens, bed sheets and curtains.”

Shaibaan prepared grounds for sowing vegetables in the recent winter season.

“I prepared half an acre of land in my garden to plant spinach, mustard leaves, coriander, radish and fenugreek. I plan to sell the surplus in the local markets and support my family financially.”


ⁱ Roti is a round flatbread native to the Indian subcontinent made from stoneground wholemeal flour and water that is combined into a dough.

ⁱⁱ Germination is the process by which plants, fungi and bacteria emerge from seeds and spores, and begin growth

Saba, 25, resides with her eight-member family in Mohallah Railway station at Pithoro Taluka[1]. Her home is three kilometers away from Community World Service Asia’s health center in Pithoro of Umerkot District. Saba was in her third trimester in November 2020.

“My husband worked in a textile company as part of the skilled labor before he lost his job amid COVID-19 and was earning PKR-15,000/month. In August 2020, he was diagnosed with Hepatitis. It has been difficult to make ends meet, as my husband was the sole bread earner. We had to take loan from relative to keep our livelihoods going.”

Diarrhea, Tuberculosis (TB), Hepatitis, skin infections and malnutrition are some of the more common health problems reported among communities in Pithoro. During Covid-19 it was very difficult for these rural communities to access medicine and other health services as most humanitarian organisations were unable to operate due to strict restrictions or closures of offices.

“I was able to visit the health facility for checkups as the women medical staff at the Mother Neonatal Child Health Centre is very comforting and efficient in healthcare delivery.”

Saba visited CWSA’s health facility with her sister-in-law for the first time in her first trimester.

“I was so pleased with the health services. The medical doctor conducted a thorough check-up and prescribed some medicines, which I easily got from the pharmacy free of cost. The medical team also gave a health session to maintain a healthy diet and shared a diet plan for me to follow. I strictly follow the plan and it has been very beneficial in terms of health. I did not feel weak or tired throughout my pregnancy period.”

Saba has to face some challenges due to the unavailability of laboratory services in the health facility.

“We have to travel to Mirpurkhas for blood tests, Ultrasound, Hepatitis, Urine-DR and blood CP. Moreover, the tests can be expensive with one blood test costing up to PKR 1500 (Approx. USD 9) in the district’s laboratory. People in my neighborhood do not have sufficient income to manage their household expenses. For this reason, we cannot afford additional expenses of healthcare at quality medical facilities.”


ⁱ A tehsil (of taluka) is an administrative division in some countries of the Indian subcontinent that is usually translated to “township”.

“For years, I have been chopping wood and selling it in the local market known as Pithoro Market. The COVID-19 lead lockdown imposed in our district minimised work opportunities for many of us. Market places had been shut down and people stayed indoors with no opportunity for businesses to operate or grow. Consequently, I was also unable to sell the wood and earn any sort of income. To further add to our worries, we also lost our home during the heavy rains in August (2020). Our house was made of mud and was fragile. We were forced to move out of the village as most of the village was flooded with rainwater. To survive, we built a tent near the main road on a nearby higher ground as a temporary shelter. We have been living here for weeks now. We plan to rebuild our home as soon as the land dries out and return to our village.”

Jarviz is a father to five children and belongs to a remote village named Saint John Colony, located in Talka[1] Pithoro in district Umerkot of Sindh. He is the sole breadwinner for his family despite being physically disabled due to polio at a very young age. Before COVID-19 hit the country, Jarviz earned PKR 200 daily (approx. USD 1) which was not quite sufficient to cover all the needs and expenses of his family of seven (including himself) but the family stayed together and lived on a day to day basis. Jarviz has been a strong man and always helpful towards everyone he knew and is therefore an inspirational member of the community’s Village Committee for over a year now.

“I have been a member of Saint John Colony’s Village Committee (VC) since its formation in August 2019. We are ten members in total with equal numbers of both genders. The committee is formed to ensure community participation and facilitate Community World Service Asia’s (CWSA) health project team in project planning, implementation, and coordination with government line departments and other NGOs. The main objective is to address the problems and needs of the community together. As an active member, I have been involved in conducting health sessions and organising free medical health camps with the project team in remote villages in the area,” shared Jarviz Masih. 

Jarviz also remotely took part in the health sessions conducted by CWSA’s health team on COVID-19 safety in May and June 2020, under its health program.

The sessions sensitised me on social distancing, hand washing, using protective gear and avoiding public gathering to eliminate the transmission of the virus. In addition, the team held sessions on family planning and health and hygiene. One of the key purposes of these sessions were for VC members to replicate the teachings in our communities to make communities aware on COVID-19 preventive and safety measures as much as possible. I myself delivered sessions sensitising 157 people in my village in the following two months. The health team has been continuously providing remote counselling and educating us on accessing Taluka hospitals in case of emergency or other general health issues.”

“In one instance, a woman in our neighborhood delivered a baby at home in an emergency. After her delivery, due to high blood pressure, she suffered from fits. I immediately contacted the health team and they advised us to immediately head towards the THQ[2] Pithoro, as the medical staff of the government was available there. The paramedic in Pithoro referred the women to the Female Medical Officer in Mirpurkhas hospital. The timely counselling and consultations benefitted and the woman was safely and immediately admitted to the hospital and is being treated well,” narrated Jarviz.

As a humanitarian response to the COVID-19 crisis, Community World Service Asia (CWSA), with support of United Methodist Committee on Relief (UMCOR), implemented a project addressing the immediate needs of affected communities in Umerkot district in Sindh province of Pakistan. Jarviz was selected as a participant of this project.

“A cash assistance of PKR 24,000 was provided to me and my family in two installments in the months of August and September 2020. With the money received, I purchased groceries for my family to put food on the table. In addition, I bought some clothes and crockery items for my daughter as her wedding is planned in a month’s time. The assistance was very beneficial and timely for me and my family.”


[1] A tehsil (of taluka) is an administrative division in some countries of the Indian subcontinent that is usually translated to “township”.

[2] Taluka Headquarters

Under the Enhancing disaster resilience against droughts in Sindh Province project, supported by the Ministry of Foreign Affairs, Japan,[1]  eight Disaster Risk Reduction (DRR) committees have been set up in eight villages, with fifteen members in each. Established in April 2019, the committees work towards strengthening the local community’s capacity to manage emergencies and collaborate with government agencies and relevant authorities to reduce risks during emergencies. These DRR committees play a pivotal role in facilitating the implementation and oversight of the project and to ensure community ownership and inclusion to maintain its long-term sustainability.

As physical interaction and implementation of any kind was not possible after the nation-wide lockdown imposed due to the COVID-19 pandemic in the country since March, Community World Service Asia’s DRR team got in touch with the members of the committees through mobile phones. Together they discussed ways of raising community awareness on COVID-19 symptoms and how to stay safe from it. Upon agreement, training sessions with the DRR committees were planned and conducted in April 2020.

Haji Chanesar village in Umerkot district was one of the selected areas and five members of its DRR Committee were part of the remote training session. They were informed about what communities should be doing to be prepared to respond to a case, how to identify a case once it occurs, and how to properly implement the preventive measures to ensure there is no further transmission of the virus.

Prem, 28, is married and a father to three children. After completing his intermediate, he was engaged in different volunteer work as he had grave interest in helping others. As a member of the DRR Committee, he looks after and operates the RO plant established in the village and also supports in the implementation of the project activities. Prem, who is an active member of the DRR Committee of Haji Chanesar village was one of the participants in this training.

The trained members of the committee then replicated the learnings separately in a number of neighbouring villages. Over two hundred local community members were introduced to information on COVID-19 and learnt basic hygiene measures to protect against the infection. By the end of these awareness sessions, communities were able to identify basic symptoms of coronavirus, common transmission channels, how to assess the risk of infection and key preventive measures.

An isolation room was established in Haji Chanesar, in case anyone is infected or is suspicious of being infected. The sessions alerted the villagers and they followed all SOPs[2] strictly especially at homes.

“In my home, none of my children go out to play nor does my wife socialize with her friends or family. We have limited our external activities, and we only go out when food or important household commodities need to be purchased. We have been fortunate till date as no case of coronavirus has come up. To prevent the spread of the virus in our area, we remain secure at home and maintain physical distance,” Prem concluded positively.


[1] Disaster Risk Reduction
[2] Standard of Procedures

“I earn PKR 300 everyday (Approx. USD 3) working at a brick kiln. I also own ten acres of farmland; however, the cultivation is far less due to lack of rainfall and proper irrigation in the area. This year I was only able to grow Guar[1] on the field as the cash assistance provided by Community World Service Asia was consumed for tillage on the land. I purchased Guar seeds from a loan I took from a local seller. I am confident that I will be able to pay off the loan after the harvest season,” shares Mangal, a resident of Vickloker village, located in Umerkot. He lives with five other members of his family. Before the locust attacks they all lived a comfortable and content life together.

In 2019, Mangal cultivated Guar on his land, but the locust invasions completely destroyed the crops. The attacks proved to be catastrophic for the local crops in most parts of Southern Pakistan. Lack of harvest in the area affected the livelihoods of many farmers.

“The earnings we received after selling the crops helped us fulfil our family needs and household expenses. Sadly, this year we had nothing to sell or earn. The local farmers have followed conventional approaches to combat the attack of the locusts. These techniques included making noise and the use of fire smoke. Unfortunately, these attempts did not help much and most of the fields were left bare and eaten. As a result there was no harvest season.”

As part of an Emergency Response project, Community World Service Asia (CWSA), supported by Japan Platform, provided cash assistance to 1600 agrarian families this August. Rural families whose livelihoods were most affected by locust attacks and COVID-19 received conditional cash grants that helped farmers to plough lands to eradicate locust eggs before hatching.

“If effective steps to stop the hatching of new eggs are not taken, existing crops will be destroyed and this will eventually have a significant impact on farmers’ food security and welfare. However, the support we got this year saved us.”

Mangal’s family was among families that received a cash grant of PKR 13500/- (Approx. USD 86) under the emergency response project in Umerkot.

Mangal plans to save some of the harvested crops for household use and sell the rest in the local market as a means of livelihood.

“The money is going to help me repay the loan I took earlier to manage household expenses and to help me buy food for my family.”


[1] Guar is an important legume crop. It is cultivated for fodder as well as for grain purpose.

Chothay is a 26 year old mother of three who lives with her husband, Kapil and children in Haji Chanesar village of Umerkot.

“My husband teaches at a nearby private primary school. We also grow cotton and wheat as joint croppers on a 5-acre field close to our house. Together with my husband’s salary and our earnings from the field, we bring home an income of PKR 15,000/- (Approx. USD 91) every month.”

Most of Chothay and Kapil’s income is spent on household utilities and ensuring to provide three meals for their children. The couple’s elder daughter attends a private school in the locality for which they pay a monthly fee of PKR 1000/- (Approx. USD 6).

“We are used to cooking on conventional mud-made stoves, which have one burner that results in contiguous smoke emissions. This meant more fuel consumption and the fire was hard to manage. The intense fire also damaged cooking utensils and left dark stains on all our crockery and cutlery. With the fire being unmanageable due to high winds, there have been many cases of houses burning down or women’s hands being burned or lungs being affected due to spending long hours in the kitchen. It even took longer to cook the food,” explained Chothay.

Gathering wood for the fire was also a laborious job often shouldered by the women in the house.

“Most of us would have bruised hands and legs when we return from fetching firewood due to the difficulty in breaking the branches and shrubs from trees and bigger plants.” 

In October 2019, Community World Service Asia conducted a training on making and using fuel-efficient stoves for twenty-five women in Haji Chanesar. The participants of the training were taught how to construct the stoves and were sensitised on its health and environmental benefits, including reduction of smoke emissions and decreased deforestation with lesser wood consumption. These trained women then replicated the same training in more than five hundred households in over sixty villages in the last ten months.

“We witnessed multiple fire flaring-up incidents in Haji Chanesar in the months of May and June last year, resulting in burnt hands, depreciated kitchen utensils and increased air pollution due to the smoke. Whereas, ever since we have started using fuel-efficient stoves, such accidents have minimised. Lesser shrubs and branches are used and cut down now which has also resulted in increased forestry and greenery,” said Chothay.

Chothay and many housewives of rural Umerkot now consume less fuel to cook as compared to when using traditional stoves.

“We are now saving time as well as energy while cooking our meals. We are coughing less and cooking more all while using two burners simultaneously. It has also reduced health risks as we do not burn our hands and less smoke is generated. We are using lesser wood which has reduced deforestation in our area and we now see more greenery in our area which is refreshing.”

Ratni is a 70-year-old widow who lives with her son and his family in Senate John Colony, located in Pithoro of Umerkot district in Sindh, Pakistan. They all live together in a cob house made of mud and straw.

“My son, Khemchand, is a teacher at a local private school. He used to earn a reasonable monthly income of PKR 8000 before COVID-19 forced all schools in the region to shut down. The school administration discontinued paying its teachers as the school was not equipped to carry out online classes and there were no incoming student fees that could cover teachers’ salaries. However, the recent monsoons brought some relief to us agrarian communities. The rains have revived the agricultural activities and have given us opportunities to work on the fields. My son and daughter-in-law started working on the fields and were able to bring home some income through that. It was not much but was better than nothing. Sometimes, I would also assist them on the field to earn a bit more to make ends meets.”

The harvest season lasts three months in rain-fed areas of Umerkot and until the next monsoon season arrives, there will be less or no opportunities to work on the fields. Therefore, Ratni, Khemchand and his wife had no work to do once the three-month period ended in August.

“We had no livelihood by then and were forced to sell some of our household possessions to buy essential food supplies for the house and particularly for my four young grand-children. We also had to take some loan from our neighbours when there was nothing left to sell.”

Community World Service Asia (CWSA), with support of United Methodist Committee on Relief (UMCOR), is implementing a Humanitarian Assistance project responding to the immediate needs of drought affected Communities in Umerkot. As part of the project, 1, 206 families will be provided with two cash grants, each of PKR 12,000 in September through mobile cash transfer services to address food insecurity caused by drought, repeated locust-attacks and the economic implications of COVID-19.

Senate John Colony’s Village Committeeⁱ provided a list of families living in the area who were most affected by the COVID-19 pandemic and other natural disasters to be supported through the project. As a result, CWSA’s emergency response team contacted Ratni as a project participant and she received the first cash assistance of PKR 12000 (Approx. USD 72).

“Through the money I received, I paid back the loans I had taken from neigbhours to survive in the last months and bought some food essentials for home. I have also saved some money to buy school books for my grandchildren for when the schools resume.”


ⁱ Village Committees are voluntary associations established for local administration. They are extra constitutional authorities comprised of 7-8 members including male and female from different caste in the village.

Dodo (far right) with his family

Dodo Maru Bheel is a 74-year-old father of two children, a son and a daughter, and a resident of Moriya village in UC Sekhro district of Umerkot, Sindh. He and his wife and younger daughter currently live with their son and his family (of six members, a wife and four children). Dodo has a visual impairment but he has never considered that as a disability or something that would hinder his life plans or goals. He is as resilient as can be and everyone in the village admires his determination and strength.

Dodo experienced a fatal road accident a few years ago. Due to an unavailability of an ambulance or timely first aid in the area, Dodo was unable to access appropriate medical facilities which further worsened his injuries from the accident. Since his financial conditions were unfavourable, he could not even afford most of the prescribed treatment at a bigger health centre in the nearest urban city. Dodo suffered a severe head injury which eventually lead him to lose his eye-sight completely.

With his sudden visual impairment, Dodo was unable to find any employment or paid work. He used to work as a daily labourer in the Umerkot city and surrounding areas. The elderly couple, along with their daughter, hence became financially dependent on their son. Their son, a daily wager, worked as a mason and the money he earnt barely met his own family’s basic day-to-day expenses, let alone a whole household of now nine members.

As the COVID-19 pandemic hit Pakistan, the government imposed a country-wide lockdown to restrict the spread of the virus. Many daily wagers lost their jobs during the lockdown; Dodo’s son was among them. The family could barely afford a single meal a day. Dodo and his son were struggling to keep their house running and their families fed. This dire situation prompted Dodo to sell a few of his goats during the days leading up to Eid-ul-Adha in late July 2020. His goats were his only remaining livestock and a supporting income means. Dodo also borrowed some money during the early days of the lockdown from a local landlord to meet their household expenses.

In April 2020, Dodo’s wife had received cash assistance of PKR 12000 (approx. US $ 71) from Ehsaas Kafalat Program as a part of the government’s COVID-19 relief fund. With that amount, Dodo and his wife planned to run a small scale, home-based business but his former creditors pushed him to pay back his loans with that amount so he was unable to use it for anything else.

The lockdown in the country has now eased but COVID-19 has left the country in a severe economic crisis that has pushed many underprivileged communities into poverty. Dodo and his son sold almost all the resources they had to sustain their family’s survival needs and are left with nothing now.

Community World Service Asia and UMCOR have initiated a project to respond to the needs of hazard and COVID-19 affected marginalised communities in rural Sindh. As part of the project, together with the support of village committees, the project selected Dodo as a participant of its cash-assistance. This will ensure that Dodo receives PKR 24000/- in two monthly installments to start his own small scale, home-based business.

Dodo and his family are happy to be selected and are looking forward to efficiently utilising the cash that they will receive next week and returning to a somewhat normal semblance of their life, as they did before the COVID-19 crisis. Dodo also hopes to save some of this money to consult an eye specialist for his eye-sight treatment.

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