Child Rights

Islamabad, Pakistan – Staff nurse Razia Noreen was at a medicine cupboard on the nursery ward of the Pakistan Institute of Medical Sciences (PIMS), Islamabad’s largest public-sector hospital. She was two doors from the babies in her care, preparing the morning’s injections.

As she shut the cupboard door, she saw through the nursery’s glass panel a light too sharp and too red to be anything ordinary. She did not wait to understand what it was.

It was 6:38am on Wednesday, August 26. Elsewhere in the ward, her colleague, Sister Nasreen, was already running out, shouting for help.

At 56 seconds past 6:38am, according to security camera timestamps later logged by a government inquiry committee, Noreen rushed into the nursery.

Eight seconds later, she emerged carrying a baby. She tried to go back in. She could not. By 6:40am, the room was gone, swallowed by smoke so thick that the security cameras could no longer see through it.

Noreen was recalling this eight days later, in a plain office beside the hostel warden’s room at PIMS, dressed in a pale pink shalwar kameez, her dupatta loose over one shoulder.

“There was a proper blast,” she told Al Jazeera. “Everything turned to smoke.”

Fifteen newborns had been in that nursery. Fourteen died. The baby Noreen carried out was the only one who lived.

On Thursday, Noreen was given an award by Prime Minister Shehbaz Sharif for her courage. But for the nurse, the trauma of that Wednesday morning was still raw.

Barely two hours after meeting the prime minister, she sat down and talked, at length, about what happened inside.

‘Save the babies’

Noreen had been on duty since 8pm the previous night, working a routine dawn medication round with Sister Nasreen, with less than two hours left before the end of her shift.

When she saw the light through the nursery glass, she says she did not stop to work out what it was.

“I just told my sister nurse, save the babies,” she told Al Jazeera. “I went in. I didn’t think about what would happen next.”

Noreen said the fire was coming out of the side of the air-conditioning unit facing her.

“The AC was right in front of me, and the fire was coming out of its side,” she said. “We don’t know what was happening behind it. That’s just what I saw.”

The government’s interim inquiry, submitted on August 28, states that the precise cause of the fire “is not yet conclusively established”, with evidence pointing variously to the air conditioner, an incubator or an electrical short circuit.

Inside the nursery, Noreen reached the nearest baby. There was no time to choose between 15. She carried the infant out and handed her to Dr Abdul Rehman, a doctor who had been inserting a feeding tube in the next room and emerged into the corridor moments after her. Then she turned back.

“I thought I’d get five, six, seven, eight more of them out,” she said. “But the fire was moving faster than I was.”

A second doctor, Dr Rimsha, who had been doing rounds nearby and saw the same light Noreen had, followed her in.

The two of them, and later Sister Nasreen, tried to crawl back through the smoke below the worst of the heat. A sudden loss of power plunged the room into darkness. They could not get through.

Noreen’s phone, left behind on the medication table when she ran in, sat inside the burned ward overnight. Hospital guards found it and returned it to her the next afternoon. Its case is still scorched and cracked.

Noreen, Dr Rimsha and Sister Nasreen instead moved to where a separate rescue team was lowering babies from an adjoining gynaecology ward. They stood there catching newborns and running them to the neonatal intensive care unit until the smoke became too thick to remain.

The government’s inquiry later found that the available evidence “does not support generalised allegations that front-line medical and nursing staff simply abandoned the newborns”.

Ask Noreen what a nurse is to a newborn separated from its mother, and she has one answer: its first mother.

“A mother who gives birth endures a pain no one else can stand in for,” she said. “But once a baby is in our hands, no one else is watching over it the way we are, checking their oxygen, their feeding, whether they’re breathing right, every two hours, whatever else is happening around us. That is why we are their first mother.”

‘I am very happy with the children’

Noreen, 38, has spent 21 years in government nursing, the last 17 of them at PIMS. She trained in Karachi right after school, at the age of 17, before a transfer brought her to PIMS in 2009. She has never married.

“Thank God, I am very happy with the children,” she said, when asked about it directly.

Born in Punjab’s city of Sahiwal, she was one of seven children. Her father, Victor John, was a pastor; he died when she was in the eighth grade. Two of her sisters have died; a third, also a nurse, lives in Lahore.

Her mother, 83, a retired government school teacher who is hard of hearing, lives in Lahore with one of Noreen’s brothers.

Noreen herself has lived in the PIMS staff hostel, across from the ward where she works, for most of the past two decades.

With her own phone trapped inside the burning ward, Noreen could not call her family herself.

Noreen’s niece happened to be staying with her that week. It was the niece the warden found, and who got word to the family in Lahore: Noreen was safe.

‘It’s always the two of us’

On the morning of the fire, Noreen and Sister Nasreen were the only two nurses on duty in a nursery holding 15 babies, backed by two doctors, one of them two rooms away. She says it was not an unusual night.

“Sometimes there are 20 babies, sometimes 25,” she said. “It’s always the two of us.”

Doctors on her ward work 36-hour shifts, she said, arriving at 8am and going off duty at 2pm the following day.

Handover between nursing shifts, checking each baby’s medication, feeding and vital signs, takes roughly 45 minutes given the numbers involved. The cost of drugs can also run to tens of thousands of Pakistani rupees per injection, all provided by PIMS to its patients.

“Sometimes we get a break, sometimes we don’t,” she said. “When the workload is heavy, even the water we carry with us goes back home untouched.”

No fire drill had been run in the nursery before August 26, not even after an earlier fire at a nearby PIMS hostel in July.

Asked what is required after an incident like this, she does not hesitate.

“We should all have proper drills. If a fire starts, everyone needs to already know what to do.”

She lists what should follow: extinguishers within reach, cross-ventilation to clear smoke, and a rehearsed evacuation route for babies who cannot walk or call out for help.

‘Golden letters in history’

Until the fire, almost nobody outside her own ward knew her name, Noreen says.

“I have almost no presence in the main hospital,” she said. “Nobody there knows who I am. I work in the nursery, in my own department. I never imagined that saving one baby would take me this far.”

She travelled on Thursday to meet the prime minister in a car the government sent.

During the meeting, Sharif called her “the nation’s daughter” and said her act would be remembered “in golden letters” in Pakistan’s history.

He confirmed Noreen will formally receive the country’s Sitara-i-Khidmat (Star of Service) award at a ceremony on March 23, and handed her a cheque for 10 million Pakistani rupees ($36,000).

She used the meeting to say what she had already told her own colleagues privately.

“My fellow nurses work with just as much dedication,” she said. “This was a very heartbreaking incident.”

‘I haven’t slept since that day’

Eight days on, Noreen is unwell. She has had a fever of 102 to 103 degrees Fahrenheit (38.9C to 39.4C) on and off, and a cough she says came from smoke she breathed in from the fire that morning — a morning she will never forget. She takes an antibiotic and sleeping tablets at night. Neither has worked as it should.

“I haven’t slept, not since that day,” she said. “I take the tablets, I drink the cough syrup, but sleep doesn’t come. I close my eyes, and I open them again.”

Asked whether the same dawn shift keeps replaying in her mind, she did not need the question finished.

“The whole incident. The same babies. The mothers’ screams, and the babies’ screams, how they must have screamed. Those are the things that don’t let me sleep.”

She was signed off on medical rest only the day before this interview. Colleagues have been steadying her since.

“I would just start crying, sitting there,” she said. “They supported me like I was a child.”

But the nights are still hers alone.

“It comes back to the same thing,” she said. “When I’m in the hostel, when I’m alone, it all comes back.”

‘That, I regret’

The baby Noreen carried out — she hasn’t been named yet, according to the nurse — remains in the neonatal intensive care unit a week on.

Born preterm at just over a kilogramme (2 pounds, 3 ounces), the baby was already unwell before the fire. She remains critical.

Noreen met the baby’s parents for the first time the day before the meeting with the prime minister.

“She [the baby’s mother Asifa] hugged me and thanked me, and cried, and I cried with her,” Noreen said, “because for the rest of the children, my heart is still exactly where it was.”

She has told the mother the same thing she tells herself.

“I said, look, your child survived such a huge storm, she will survive what comes next, too. You pray, and I will pray.”

Asked what she would tell other nurses, Noreen urged them to work with honesty and without conditions.

“When you work somewhere with honesty, the reward comes eventually,” she said. “It came to me after 21 years. Work with the same loyalty. That is our real strength.”

Then, unprompted, she returned to the 14 babies who died.

“I do regret it,” she said. “I could not save the rest of the children. That, I regret.”

As many as 20 million children in 21 countries have experienced online sexual abuse or exploitation each year, according to new findings from the United Nations children’s agency, UNICEF.

More than one in five children aged 12 to 17 in countries in Africa, Asia, Latin America and the Caribbean, and Eastern Europe have been targeted on digital platforms, according to the UNICEF report released on Thursday.

Researchers surveyed 21,000 children aged 12 to 17 who used the internet across 21 countries between 2020 and 2021, and then again between 2024 and 2025. They also conducted in-depth interviews with 100 young people who have experienced childhood abuse.

Social media facilitated more than half of the abuse cases, according to UNICEF, which cautioned that figures could be inaccurate due to underreporting by children. Less than 1 per cent of all abusive incidents were reported to authorities, the researchers found.

Last week, US social media giant Meta agreed to a landmark $18bn settlement in a major US federal case accusing the company of endangering children. Meta has faced an avalanche of legal cases this year, most arguing that it has deliberately designed its platforms to be addictive and that they have harmed children. The company has now agreed to make major changes to the features of its social media platforms.

What are the key findings of the UNICEF report?

The report estimated that in the periods studied, more than 15 million children were exposed to unwanted sexual content, nine million were asked to engage in sexual conversations or share sexual images against their will, and four million children had sexual images of themselves shared without their consent.

UNICEF said the issue is compounded by the fact that children often don’t recognise abuse or know who to report it to, and fear repercussions if they do. Formal systems can feel distant, complex or intimidating, the report noted.

“The report reveals a painful reality. More than 20 million children across the countries studied were subjected to unwanted explicit sexual content or exploitation online, often in the digital spaces where they learn, play, and connect with friends,” said UNICEF Executive Director Catherine Russell. “These experiences cause profound emotional and mental distress. Many children suffer in silence, unsure where to turn for help. We cannot look away.”

Where was data collected?

Information for the report was based on nationally representative survey data collected between 2020 and 2025 from approximately 21,000 internet-using children from the following countries:

• Eastern and South Africa: Ethiopia, Kenya, Mozambique, Namibia, Tanzania and Uganda 
• Southeast Asia: Cambodia, Indonesia, Malaysia, the Philippines, Thailand and Vietnam
• Latin America and the Caribbean: Brazil, Colombia, the Dominican Republic and Mexico 
• Eastern Europe: Armenia, Montenegro, North Macedonia and Serbia
• South Asia: Pakistan

Where are children being abused?

Abuse often begins in public spaces, such as in schools or local neighbourhoods, before moving to digital spaces which can further facilitate harm.

Social media and messaging platforms enable different stages of abuse, “including initial contact, relationship-building, sexual solicitation, image-sharing, coercion, blackmail and the continued circulation of sexual content”, the report said.

Sometimes abuse takes place solely online.

According to the report’s findings, more than 60 percent of cases occurred on social media platforms, with the majority on Facebook (50 percent), WhatsApp (29 percent), Instagram (24 percent), SnapChat (13 percent) and TikTok (12 percent).

Do children report abuse?

Most children do not seek help if they are being abused. Less than one percent of cases are reported to the police, a social worker or a helpline, while more than four in 10 cases not being disclosed to anyone at all.

“Children are not failing to report; they have correctly worked out that there is nowhere to report to,” Nighat Dad, executive director of the Pakistan-based Digital Rights Foundation, told Al Jazeera.

Dad, whose NGO works to provide safe online spaces in Pakistan, noted that incidents repeatedly occur online because of a “design problem – the message request, the move to a private chat, the reshare, the ability to return after being blocked”.

Many children minimise their experiences or do not recognise when they’ve been abused, she said.

Even when children do speak out, to a close friend, sibling, or parent, doing so may not necessarily stop the abuse or bring perpetrators to account.

UNICEF emphasised that its research interviews were the first time many of the children it interviewed had spoken to someone about the abuse they were subjected to.

Dad also cautioned that Pakistan, for example, is a “low-disclosure country” where notions of family “honour” and other cultural barriers prevent children from disclosing the harm they’ve experienced.

“A girl who speaks risks her phone, her schooling and sometimes her safety, and a boy is expected to cope in silence,” Dad said.

How does gender factor into online abuse?

Perpetrators often play on gender norms when exploiting children. Stigma and blame are used against girls to keep them silent, while boys are expected to cope alone, or threatened by perpetrators.

“Peer cultures and harmful norms around gender or masculinity can further normalise behaviours that cause significant harm, making abuse harder to recognise and address,” UNICEF noted.

What kind of impact does online sexual abuse have on children?

The repercussions are severe, UNICEF said: Children exposed to technology-facilitated sexual abuse and exploitation are four times more likely to have suicidal thoughts and to self-harm, along with higher levels of anxiety.

In Mexico or North Macedonia, for example, the risk of suicidal thoughts or behaviours was more than eight times higher among children who experienced abuse, while in Pakistan the risk of self-harm was more than seven times higher than average, the report found.

Abuse extends well beyond the digital sphere, seeping into children’s everyday lives, schooling and relationships.

What should be done about this?

UNICEF said the onus to protect children online must be placed on governments and technology companies, which must change how online spaces are designed and regulated.

It also highlighted that while children often take steps to protect each other, societies, schools and families must work to shift the burden of protection away from children.

Citing Meta’s recent settlement, Dad acknowledged that design changes, such as better age verification and parental controls, can and should happen.

“For years those of us working outside the US were told these defaults would break the product. Meta has now shown the product can change.”

A spokesperson for Meta told Al Jazeera, “This report is based on surveys from as far back as 2020, before we introduced the protections UNICEF recommends, like automatically defaulting teens into private accounts and preventing adults from messaging teens they’re not connected to.

“While the report doesn’t provide any specific evidence of abuse, we’ll continue to fight child exploitation aggressively across our apps and support law enforcement in prosecuting the criminals behind it.”

The spokesperson also pointed out that Meta-owned WhatsApp is a private messaging service rather than a social media platform. “We don’t have algorithms that make a piece of content more or less likely to be viewed, and you need someone’s phone number or exact username to connect with them for the first time.”

Snapchat and TikTok have not responded to requests for comment for Al Jazeera.

Andhra Pradesh’s regional minister of education says he is taking legal action with a committee against those responsible.

Authorities in the Indian state of Andhra Pradesh have launched an investigation after a six-year-old child collapsed and reportedly died after he was slapped by his teacher in a school classroom.

The incident was captured on a security camera in the school in Visakhapatnam in the southeast Indian state, before being shared widely by local media on Thursday. The incident is already causing an uproar around corporal punishment in the country.

The video clip, which has been verified by Al Jazeera, shows a female teacher holding a child by his clothes before slapping him on the face, after which he collapses.

“We are taking legal action against those responsible and the school management,” Nara Lokesh, Andhra Pradesh’s education and IT minister, wrote on Facebook on Thursday.

Police are also investigating the circumstances around the death of the child, who local media have named as Pranay Tej.

“As a father, I can’t get over what happened to little Pranay Tej. I cannot imagine the pain his parents are going through. Corporal punishment has no place in our schools. No child should ever be subjected to violence in the name of discipline,” Lokesh wrote on X on Friday.

“I have already directed a full investigation and strict action against anyone found responsible. My heart goes out to Pranay’s family in this moment of unimaginable grief.”

Relatives gathered at the hospital after learning about the boy’s death and demanded strict action against those responsible, according to NDTV India.

Pranay Tej’s father said his son appeared healthy in the morning before going to school. “In the morning around 8am, my son woke up and said he wanted to go to school. He insisted on going to school,” he told NDTV.

Police Inspector Pudi Vara Prasad told Press Trust of India: “Following a written complaint from the boy’s father, we have registered a case under Section 194 of the BNSS and launched an investigation.”

Prasad said the body was handed over to his parents after police “completed the inquest and post-mortem procedures”.

He added that “once all relevant reports are received, we will determine the exact cause of death”.

A 2018 study by the Indian NGO Agrasar found that roughly 80 percent of low-income school children in India experience corporal punishment from teachers, despite it being officially illegal.

Palla Srinivasa Rao, Andhra Pradesh state president of the Telugu Desam Party (TDP), told Press Trust of India that “the government has reacted appropriately” in the aftermath of the incident.

“Our IT and Education Minister, Nara Lokesh Garu, has already formed a committee, and based on the committee’s report, we will definitely take action,” he said.