The Need for Care Reform in Pakistan

Provincial authorities should review the residential childcare facilities under them, including those run by private organizations and charities.
By: Amir Murtaza
In Charles Dickens’s Oliver Twist, a hungry orphan stands in a workhouse with an empty bowl and says, “Please, sir, I want some more.” The adults are outraged and the boy is punished for asking. Oliver had a bed and a bowl of thin gruel, but nobody was looking after him as a child. The book came out almost 190 years ago, and many of us still believe a bed and a meal are all a child needs.
The death of 15-year-old Waseem Abbas in Multan should make Pakistan face a question we have ignored for too long. Are we protecting children by putting them in orphanages, or are we so used to institutional care that we rarely ask whether children need to be there at all?
Waseem was living in an orphanage run by an NGO. About a week before his death he was sent to an electrical contractor to learn a trade. On 20 October 2026, police say, the contractor chased him in a car and ran him over in a private housing society in Multan. Reports say the boy did not want to continue the work because of the contractor’s alleged ill-treatment. CCTV footage shown by news channels shows the boy running before the car hits him. Police registered a murder case and are looking into what happened, including the role of the contractor and of the institution where Waseem lived.
The case then took another bad turn. On 21 October, news organizations reported that the main suspect, Tauqeer Nazir, had been killed in an alleged encounter with Punjab’s Crime Control Department near Bahawalpur, after he reportedly escaped from police custody. The CCD says he was hit by bullets fired by his own accomplice. How he escaped and how he died need their own investigation. The questions about Waseem’s placement and the responsibility of those who were looking after him also remain.
These events are still developing, and allegations are not the same as proven facts. But one thing is already clear. Waseem’s death needs more than public anger. It needs serious questions about the systems that are supposed to protect children.
For many years I have worked in child protection and alternative care in Pakistan and Afghanistan. My work has included visiting residential childcare institutions, looking at care practices, helping write minimum care standards, and pushing for family-based alternatives.
One worry has stayed with me throughout this work. Pakistan too quickly treats institutional placement as the answer to a child’s vulnerability. We do not ask enough why the child was separated, or whether the family could look after the child safely with the right support.
A child may enter residential care because a parent has died, because the family is poor, because a parent is ill or absent, because of family conflict, or because the child was found alone and no caregiver was available at that time. These situations are different and need different responses.
But the word orphan hides these differences. A child whose father has died may still have a mother, brothers and sisters, grandparents, maternal uncles, paternal relatives or others who could care for him. A child living in poverty may need money, schooling, healthcare and support for the family, not separation from it.
We must also remember that children in residential institutions are not all the same. Some have no safe family option. Others need temporary protection while their family situation is checked. Some were separated only because their families did not have the means to look after them. Each child’s own situation, wishes and needs should decide the response.
The reported facts of Waseem’s death raise one important question. What safeguards were in place when he was sent outside the institution to learn electrical work? Vocational training can be useful. Children and young people should get a chance to learn skills, become independent and prepare for adult life. But sending a child to work with an outside contractor is not just a decision about education. It is a decision about the child’s safety.
Who checked whether the placement was suitable? Was the contractor properly checked? Was the work suitable for a 15-year-old? Was there a clear plan for supervision and follow-up visits? Did Waseem have a safe way to complain or leave if he felt threatened? Who was responsible for checking how he was doing?
These questions are not meant to decide the criminal case in advance. They are about the responsibilities that should exist whenever an institution places a child with an outside person or organization.
A child does not stop being the institution’s responsibility just because he or she has been sent somewhere else. A vocational placement is also not a success just because a child has been given a skill to learn. Safety, dignity, the child’s own agreement and proper supervision must be part of the arrangement.
If what has been reported in Waseem’s case is proven, it will matter well beyond one placement. We will have to look at the safeguards for how residential institutions arrange education, work, vocational training and other activities outside their premises.
The answer to this tragedy should not be to call every orphanage unsafe or to assume that everyone working in residential care is doing wrong. Many people sincerely work to give children shelter, education and care. But good intentions are not a substitute for accountability.
Every institution that looks after children must be able to show that the children are safe, that their rights are respected, that decisions are based on each child’s own assessment, and that independent bodies exist to find and fix failures.
The investigation into Waseem’s death should find out what happened in his case, including the responsibilities of the adults and the institution involved. Beyond that, the government should start an independent review of residential childcare facilities across Pakistan, with proper provincial arrangements and national coordination.
Such a review should not stop at checking buildings, counting beds or seeing whether food and clothes are available. These things matter, but they do not tell us whether a child is safe, whether separation was needed, or whether the child’s needs are being met.
The review should look at why children come into institutions, how their family situation is checked, whether family tracing is done, whether sending the child back home is actively considered, and whether safe care by relatives has been explored. It should look at how children are chosen for outside placements, how those placements are monitored, whether children can complain in confidence, and whether they are protected from violence, exploitation and neglect.
Children must also be asked about their experience, in a way that suits their age and situation. Institutional records alone cannot tell us everything. A file may call a placement successful while the child feels scared, alone or unable to talk about what is happening. Independent access to children, private interviews, working complaint systems and protection from revenge are therefore necessary.
The review must also check whether institutions keep children’s identities and family links, help them stay in contact with relatives where appropriate, and plan for their future after residential care. Where failures are found, someone must be clearly responsible for putting them right and, where needed, there must be legal action.
The aim is not to blame institutions unfairly. It is to make sure no institution works on the belief that giving a child a place to stay is enough to meet its duty of care. Scrutiny and care reform cannot be separated. Pakistan must move away from an approach that mostly deals with children after they are separated from their families. It should first ask whether the separation can safely be prevented.
For a family in financial trouble, proper social protection may decide whether a child stays at home or goes into residential care. For a child who has lost a parent, support for the surviving parent or the wider family may be a safe alternative to an institution. Where a child cannot safely go back to the parents, care by relatives or other suitable family-based arrangements may be possible.
This does not mean that families should be seen as safe in every case. Sending a child back to the family must be based on an individual check of safety and the child’s best interests. Where a child has faced abuse, violence, neglect or other serious harm, protection comes first. Keeping families together must never become an excuse for sending a child back into danger.
Care by relatives should also not be seen through rose-colored glasses. Relatives who take on a child may themselves face poverty, poor housing, health problems, school costs and other pressures. They need practical help, follow-up visits and access to services. Without this, moving responsibility from an institution to the extended family may only move the burden without solving the real problems.
The aim is not to replace one unsupported arrangement with another. It is to build a system where children can grow up in safe, stable and caring family settings wherever possible.
Residential care will still be needed for some children. When there is no safe family option, children need proper alternative care, trained caregivers, independent oversight and individual plans for their future. Such care should be based on need, suitability and the child’s best interests, with regular reviews, not an open-ended placement by default.
One of the hardest parts of care reform is accepting that some children enter institutions because their families cannot give them the material conditions that society expects.
A family may love its child and want to keep him but still be unable to pay for enough food, rent, healthcare, transport or school. If residential placement is the only response available, poverty can in effect separate children from their families.
This is why child protection cannot work separately from social protection. Financial help, access to schooling and healthcare, support for disability, counselling, ways to earn a living and social work services can help families stay together safely. These cost money, but they also show that family separation is not always unavoidable.
The question should not only be whether an institution can give a child food and schooling. It should be whether the same child could safely get these things while living with the family, with the right help. The answer will be different for each child. That is exactly why individual assessment is a must. The effects of institutional care cannot be judged only by the quality of the building or the number of services given.
Children need lasting relationships with adults they can trust. They need chances to stay in touch with family, to understand their own history, to build a sense of who they are, and to take part in decisions about their lives.
For children who grow up in residential care, these needs continue through childhood and the teenage years. Turning 18 does not make someone ready to live alone. Young people leaving care may need continued help with education, jobs, housing, relationships, documents and decisions.
A care system that keeps children safe today must also prepare them for life tomorrow. This needs individual care plans, real participation by the child, family tracing where appropriate, regular reviews of the placement, and a realistic plan for going back to family or another suitable long-term arrangement. It also needs us to listen to young people who have lived in care, because their experience can show gaps that institutions and policymakers may miss.
Children should not have to wait until they leave care to find out that nobody planned properly for their future. Waseem’s death should lead to a response that is both immediate and long-term.
The authorities must find out how he died through a credible investigation, keep the evidence safe, and look at the role of everyone involved. The reported escape and death of the main suspect must also be investigated openly. These developments should not stop the examination of other possible responsibilities in the case.
The institution’s decisions and safeguarding arrangements must be examined independently. This includes the assessment that led to Waseem being placed with the contractor, the arrangements for monitoring him, and whether the institution did its duty towards him.
Provincial authorities should review the residential childcare facilities under them, including those run by private organizations and charities. The review should look at registration, inspection, staff, safeguarding, family contact, outside placements and individual care planning. The findings should lead to clear corrective steps and public reporting, while keeping children’s identities and private information protected.
Pakistan needs stronger and more consistent standards for alternative care. Responsibilities are divided between the provinces, but children’s rights should not depend on where they live. National coordination, shared minimum safeguards and proper provincial implementation are necessary.
Care reform needs attention and resources over a long period. Preventing unnecessary separation, strengthening family-based care, supporting relatives who care for children and developing safe alternatives all need money for social workers, family support services and proper monitoring.
A parliamentary committee could help with oversight, but it should add to, not replace, professional investigation, independent inspections, the participation of children and the enforcement of existing legal duties.
I have spent a large part of my working life speaking up for children who are separated from their families and for reforms that make family-based care a real option in Pakistan. This work has taught me that placing a child in an institution is not a neutral office decision. It changes the child’s relationships, daily life, identity and chances in life. It must therefore be justified by the child’s circumstances and best interests, not by convenience or the lack of alternatives.
Waseem Abbas’s death is a human tragedy. His life must not be reduced to a case number, a CCTV clip or a short wave of public anger. The facts of his death deserve to be established, and anyone responsible for wrongdoing must be held accountable through a credible process.
But accountability must not end with the guilt of individuals. We must also look at the systems, decisions and safeguards that shape children’s lives long before a crisis comes.
An orphanage may give shelter, but shelter alone is not a complete child-protection system. A vocational placement may promise a chance, but a chance without safeguards can put a child at risk. A family may be struggling, but poverty alone should not decide whether a child grows up away from the people who love and care for him.
Pakistan needs to prevent unnecessary family separation, help families care for their children, strengthen safe care by relatives and other family-based options, and make sure residential care is used only when necessary and under effective independent oversight.
Every child deserves a family whenever this is safe and possible. Every child deserves protection wherever he or she lives. And every institution that is trusted with a child’s care must be answerable for that duty.
Waseem’s death should be a turning point. Not because one tragedy can tell us everything about every institution, but because it reminds us how much we still need to question, investigate and reform.
Read: Children Belong in Families, Not Institutions
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Amir Murtaza is a social sector researcher. He can be reached at amirmurtaza1@hotmail.com.



