Abdul Sattar Edhi came to Karachi as a poor man from an Indian village in 1947. Starting with a small pharmacy tent, his work rapidly expanded, powered by donations from ordinary citizens. With the help of his wife Bilquis, he set up a maternal health clinic and a centre for abandoned children. A large donation allowed Edhi to buy a second-hand truck, which he put to use as his first ambulance.
Pakistan can sometimes be a cruel environment, its residents caught between the dual pressures of poverty and violence. Yet it is also a place of great kindness, with a strong culture of charitable giving. Donations from what Edhi called the common man still power the foundation. It refuses state money, and has politely turned down donations from businessmen that it considers unethical. The organisation fills many gaps left by the state, operating a dizzying array of services, including homes for victims of domestic violence, food banks and a shelter for stray animals.
Kazmi has a persistent cough and frequently quotes Karl Marx. Despite the heat, he wears a woolly hat and a waistcoat over his salwar kameez. Im leftist-minded. Edhi Sahib was too, he tells me. Some 40 years ago, he said to me, You cant say when the revolution will come, but this is a way to serve the common man. Come and work with me. So I joined.
Pakistan is a conservative, religious state. The Edhi Foundation is unusual in its ignoring of caste, creed, religion and sect. This strict stance has led to some criticism from religious groups. Edhi lived in a humble, ascetic way, even as his charity became a multimillion-pound enterprise. He refused exploit his growing celebrity for personal gain, never took a salary and even satoutside the office with a begging bowl.
When Edhi died on 8 July 2016, Pakistan entered a period of national mourning. He was hailed internationally as the worlds greatest humanitarian. Leadership of the organisation passed to his eldest son, Faisal.Criticism from religious conservatives about the familys beliefs ramped up. Donations dropped. Pakistan is now watching to see if Edhis legacy can be continued.
Like other Edhi ambulance drivers, Safdar is technically a volunteer and works for a basic salary of 4,300 Pakistani rupees a month (33). A private driver would earn 10,00015,000 rupees. This basic salary covers the high-risk rescue work; the easier patient services jobs moving people between hospitals and transporting corpses incur a small fee, so drivers receive a commission of around 100 rupees (76p) per trip. Sometimes patients tip. But clearly, money is not the motivating factor.
When Safdar talks about his medical knowledge, his face lights up. Edhi drivers receive a few days of basic instruction, and those who display an aptitude later get more specialised training on an ad hoc basis. Safdar can rattle through the correct procedure in the event of a heart attack, electrocution, broken bones, fire, bombs. He has tricks for picking up heavy people, and uses the grubby cushion in his ambulance to prop up the unconscious to keep their airways open. Doctors giving me these trainings would ask me how long I have studied for, and I would show them my thumb, he says proudly. This signifies illiteracy: those who cannot sign their name use a thumbprint for official documents. Theyd say, You seem like youve studied for a long time, because you know the right questions to ask.
Safdar and other workers care passionately about continuing Abdul Sattar Edhis legacy. Edhi was staunchly non-hierarchical, and had a personal relationship with even his most junior staff. Safdar keeps in his ambulance a dog-eared newspaper obituary, which quotes him saying that Edhi was like a father.
Between jobs, Safdar can usually be found in one of the small shops near the Kharadar base. The biryani stall dishes up heaps of steaming rice and meat to drivers on their breaks. A juice bar, with white walls and bright orange plastic seats, sells fried chicken and canned drinks. The tea shop nearby brews vats of traditional masala chai; milky, sweet, spiced tea that fuels everyone at the Kharadar office through their long shifts.
Sitting in the tea shop, Safdar pours a small amount of his tea into the saucer so it will cool quicker, slurping it up from the plate. I am always on call even though Im free right now, he says. A call comes through. In an instant, Safdar is in his ambulance. There has been an explosion in the Defence Housing Authority, an upmarket suburb of Karachi.
Safdar drives at alarming speed, weaving between lanes of traffic, careering down alleyways, his siren blaring. Edhi ambulances small Suzuki Bolan minivans equipped with a single stretcher and oxygen canister are not set up for pre-hospital care. But their small size means they can zip through the citys five lanes of frequently gridlocked traffic at high speed. Safdar shouts through his loudspeaker for people to move. Hey Muslim! Go quicker! he calls to a man with a long beard wearing a prayer hat. Rickshaw driver, get out of the way! Old lady, move it! Son of a bitch, are you drunk? He screeches to a halt outside the flats where the explosion has taken place.
The Edhi Foundationhas around 500 ambulances in Karachi, out of a fleet of more than 1,500 across Pakistan. This makes it the worlds largest voluntary ambulance service. The Chhipa ambulance service is also run as a charity, on a similar model to Edhi. Founded in 2007, it is Karachis second-largest ambulance fleet.
Safdar considers Chhipa as a rival to Edhi. I dont consider them ambulances, he mutters. As far as ambulances go, we are the dons and these guys are just kids. Once, he got into a physical fight with some Chhipa drivers. Edhi was still alive then and made sure Safdar was arrested. He wanted to teach me a lesson, Safdar says.
The Defence Housing Authority explosion was caused by a domestic gas cylinder, and four people were badly injured. The rate of injury and death in Karachi resulting from poor health and safety standards is particularly noticeable now that tightened security has reduced violent crime.
Pakistans security crackdown was triggered by two major incidents in 2014. The most shocking was a Taliban attack on a school in Peshawar, one of the countrys northern cities, on 16 December, in which more than 150 people, mostly children, were slaughtered. The other, which happened six months earlier, on 8 June, was a brazen assault on Jinnah international airport in Karachi. Around 11pm, 10 heavily armed militants entered the airport and launched an assault. Heavy fighting with the Airports Security Force ensued.
A group of Edhi workers arrived at the airport soon after the first blast and provided medical back-up to the security forces. Clad in bulletproof vests, Safdar and his colleagues were inside the airport for 16 hours as the gun battle raged. During the active fighting, our job was to keep in a corner and watch for injuries and see if someone was shot, says Safdar. Workers darted out with their stretchers to pick up the wounded. Of the 28 who died, 14 were security officials.
In Karachi, a number of people were killed in the crackdown that followed. Sometimes, ambulances are called to clear up the mess.On this subject, Safdar is uncharacteristically reticent. Whether it is a big raid or a small one, back-up is needed. Sometimes we arrive and find police in masks. It is our job to check if anyone is alive, not to ask any questions.
Edhi workers have not always had an easy relationship with the police. In April 2012, the streets of Lyari broke into a new iteration of an old gang war. The police staged a crackdown, shutting down electricity and water. Police and gangsters battled in the streets. Thousands of people were trapped inside without basic supplies, so Abdul Sattar Edhi announced that his ambulances would deliver water, rice and powdered milk door to door. This allegedly angered police, and led to widespread conspiracy theories and unsubstantiated allegations that ambulance drivers distributed arms to gangsters.
My job was to take groceries to homes, says Safdar. We couldnt do much for the injured as the government was involved. But lots of families had other emergencies heart attacks, going into labour. We catered for that despite the police operation.
One day, Safdar claims, he and a colleague were apprehended by Chaudhry Aslam, who was then the police superintendent. He cut open the sacks of rice, looking for weapons, and took them into custody. The incident demonstrates the dangers of operating an ideologically independent organisation in a corrupt and unpredictable state. Safdar is sanguine: My only regret is that I was not able to slap Chaudhry Aslam in the face as he arrested us.
The call comes in the early afternoon. A dead body has been spotted in the sea, near the port. Siren blaring, Safdar weaves between cars. It is not common for us to have accidents, and when we do, it is usually the publics fault, he says. A large truck fails to give way. I dont think you can even hear the horn! he shouts, glaring at the driver.
At the port, Safdar picks up the sheet from his stretcher. Bodies are harder to lift when they are waterlogged: limbs are fragile and parts can come away. When the wooden rescue boat comes in, he and a colleague climb nimbly down the rocks and onto the boat. They roll the corpse onto the sheet, wrap it around, and carry it up to the waiting stretcher. It is fresh, a few hours old, and has not started to smell. The man was in his 60s.
When a body is found, a strict procedure follows. The ambulance takes it to a government hospital, where the death is logged and if possible, relatives contacted. If no ID is found, the body goes to a police station. From there, it is taken to the Edhi mortuary, where further efforts are made to track its identity. If this proves impossible, the body ends up in the Edhi graveyard.
The Edhi mortuary is in Sohrab Goth, an impoverished area that until recently was a hotbed of urban militancy. The mortuary is set back from the road, with a large open waiting area lined with benches, where relatives can sit. To the left are rooms where the bodies are washed. To the right is the cold storage facility. This is the only functional mortuary in Karachi, a city of more than 27.5 million people.