Karachi Pilot Clinic Brings Child-Friendly Justice to Pakistan

A pilot child-friendly medicolegal clinic in Karachi has brought renewed attention to how Pakistan’s justice and health systems handle minors who enter legal proceedings as victims, survivors or children in custody. The facility, established at the Office of the Police Surgeon as part of the Anti-Rape Crisis Cell, is being presented as an effort to make evidence collection less intimidating and more sensitive for children.

The clinic was inaugurated last week and is linked to requirements under the Sindh Medico-Legal Act. Its purpose is to move away from a system in which children were often processed through the same cold, adult-centred medical and legal procedures used for older complainants and accused persons. Officials and specialists involved in the initiative say the change is essential because children need protection, clarity and emotional support at every stage.

At the centre of the model is a child-sensitive examination environment. Toys, snacks, dolls and body diagrams are used to help children communicate in ways that are less frightening than direct questioning. Examinations can also be adapted to the comfort of the child, including allowing a child to sit with a parent where appropriate rather than being forced into a rigid clinical setting.

Police Surgeon Dr Sumaiyya Syed, who is part of the government effort, has argued that violence against women and children should be treated as a “public health crisis”. She said the older approach often failed to recognise the different needs of a very young child, an adolescent and an adult survivor, creating risks of additional trauma during a process that is supposed to protect evidence and support justice.

The clinic also includes psychosocial support, a case worker and links with institutions such as the Sindh Child Protection Authority, shelter homes and other referral networks. A psychologist is stationed at the facility during working hours, while officials are also planning a later phase that may include a safe room for children who cannot immediately return home or be handed into another environment.

The medicolegal process is crucial because certificates and reports prepared after examination often become key evidence in court. In cases involving assault, age disputes, trafficking, abuse, custody, early marriage or family pressure, the medical report can shape the direction of police investigation and judicial proceedings. For that reason, experts say the process must be both legally sound and emotionally careful.

The need for reform is reflected in Pakistan’s wider child protection crisis. Child rights organisation Sahil recorded at least 2,003 child sexual abuse cases last year through media-based monitoring, with Punjab accounting for the majority, followed by Sindh, Khyber Pakhtunkhwa and other areas. Rights workers caution that reported cases only show part of the problem because many families avoid police, courts or the press due to stigma and fear.

Pakistan’s legal framework has changed significantly over the past decade, especially after the Kasur abuse scandal and the murder of Zainab Ansari pushed child protection into national debate. Amendments to the Pakistan Penal Code, the Criminal Law Amendment and the Anti-Rape Act expanded recognition of offences against children and introduced stronger procedures, including in-camera trials, survivor support and more structured investigation mechanisms.

For Pakistan, the Karachi clinic could become an important test case for trauma-informed justice. If the model is expanded, it may improve the quality of evidence, reduce retraumatisation, help families stay engaged with investigations and strengthen confidence in the system. The next challenge will be implementation beyond one facility, including trained staff, round-the-clock support, funding, monitoring and replication across provinces.