Yesterday, I sat face-to-face with a mother whose life has been carved by pain, resilience and an endless fight against the system—a system meant to support her, yet one that pushed her into exhaustion at every step.
Her child—born with a disability—did not survive. But her story survived and with it survives a truth many in Pakistan hesitate to confront: our disability support structures are burdened with procedures, but empty of empathy. Her hands trembled not from weakness, but from a deep, unresolved anger at how every point of care—assessment, certification, financial support, rehabilitation—was a battlefield. “I buried my child,” she told me, “but I am not ready to bury my voice.” Her pain has transformed into purpose and she now stands ready to advocate for change.
This mother’s narrative is not an isolated case—it echoes thousands of families across Pakistan who quietly endure bureaucratic delays, disjointed services, unclear pathways and overwhelming emotional stress. As Director of the VIPD Unit, I listen to these stories every day. And each one reinforces the urgency of rethinking disability through the lens of dignity, service integration and human rights. A system designed with good intentions—but built without people: Pakistan has policy frameworks, welfare programs and even special funds for persons with disabilities. But the operational reality is often very different.
The mother shared how she moved from office to office, carrying heavy files, photocopies and medical reports that piled higher than her strength. She described the strain of spending long hours under the sun at government counters, only to be told to “come again tomorrow.” Nothing broke her more than the feeling that she was treated as a burden, seeking a favour—not a right. These disconnect between policy and practice is where Pakistan must reflect. Disability is not a document to be stamped—it is a lived experience that requires empathy-driven service delivery. It demands that we simplify the journey, not complicate it. It calls for a system that listens, not dismisses.
The emotional labour behind every disability certificate: The paperwork for disability certification is meant to ensure transparency, but in its current form, it feels like punishment. Parents describe it as “labour without rest,” especially mothers who shoulder most of the care-giving responsibilities. They juggle cooking, cleaning, medical visits, long travel times and financial limitations—only to face procedural hurdles that seem endless. In our conversation, the mother asked me, “Why must families prove their suffering again and again? Why must they plead for support that is their constitutional right?” Her questions reflect the feelings of thousands who have lost trust in the system. These questions deserve answers—and solutions—not silence.
A call for positive reform, not blame: My purpose is not to criticize individuals or institutions, but to initiate a national conversation on improving disability services. Pakistan has committed experts, dedicated officers, clinicians and policy advocates; however, fragmented systems limit their impact. Certification, rehabilitation, financial support, education and transport operate in silos, forcing families to navigate disconnected pathways at great emotional cost. Positive criticism recognizes these efforts while acknowledging gaps—and affirms that we can and must, do better now.
How the VIPD unit is stepping forward: As Director of the Violence, Injury Prevention & Disability (VIPD) Unit at the Health Services Academy, I consider it my responsibility to transform these voices into action. We are dedicating our work to: (i) Developing a People-Centred Disability Navigation Toolkit, (ii) Initiating National Dialogue Forums, (iii) Promoting Research on Disability Burden and Service Gaps, (iv) Building Empathy Training for Frontline Staff, (v)Advocating for Digitalised, Single-Window Disability Services
A mother’s grief should become a nation’s wake-up call: As our conversation ended, the mother looked at me and said, “My child is gone, but my fight is not. Please make sure no other mother goes through what I did.” Her plea is a reminder that disability is not an individual experience—it is a collective responsibility. I write this not only as a professional, but as someone humbled by the courage of the families who struggle every day. Disability is not a tragedy—but a system that fails to support them is. The way forward: Pakistan stands at a turning point. We can continue with fragmented, unclear and stressful processes—or we can build a disability support system defined by accessibility, compassion and efficiency. Through the VIPD Unit, we partner with communities, policymakers and families to ensure that every child is seen, every parent is respected and every voice is heard. Together, we can shape a future where disability support in Pakistan is not a burden, but a bridge.
—The writer is Director, Violence, Injury Prevention & Disability (VIPD) Unit, Health Services Academy, Islamabad.
